Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $2,490.62 / $2,490.62 / $2,490.62	Facility		$2,490.62	$2,490.62	$2,490.62
Aetna Facility/Professional Professional Modifier Low / Median / High Price $2,357.35 / $2,490.62 / $4,477.02	Professional		$2,357.35	$2,490.62	$4,477.02
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $4,937.18 / $5,430.91 / $8,985.69	Facility		$4,937.18	$5,430.91	$8,985.69
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $4,270.17 / $4,591.59 / $6,072.74	Professional		$4,270.17	$4,591.59	$6,072.74
CareSource Facility/Professional Facility Modifier Low / Median / High Price $3,551.80 / $10,565.59 / $10,565.59	Facility		$3,551.80	$10,565.59	$10,565.59
Cigna Facility/Professional Facility Modifier Low / Median / High Price $2,756.64 / $10,900.96 / $20,608.58	Facility		$2,756.64	$10,900.96	$20,608.58
Cigna Facility/Professional Professional Modifier Low / Median / High Price $2,012.35 / $8,222.73 / $9,344.01	Professional		$2,012.35	$8,222.73	$9,344.01
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $1,420.87 / $3,735.93 / $5,677.77	Facility		$1,420.87	$3,735.93	$5,677.77
DeanCare Facility/Professional Professional Modifier Low / Median / High Price $2,826.92 / $4,818.83 / $5,924.63	Professional		$2,826.92	$4,818.83	$5,924.63
Medica Facility/Professional Facility Modifier Low / Median / High Price $2,459.58 / $4,937.18 / $22,996.26	Facility		$2,459.58	$4,937.18	$22,996.26
Medica Facility/Professional Professional Modifier Low / Median / High Price $2,034.92 / $2,586.26 / $5,375.99	Professional		$2,034.92	$2,586.26	$5,375.99
Molina Facility/Professional Professional Modifier Low / Median / High Price $50.00 / $70.00 / $1,727.10	Professional		$50.00	$70.00	$1,727.10
Prevea360 Facility/Professional Facility Modifier Low / Median / High Price $1,420.87 / $3,735.93 / $5,677.77	Facility		$1,420.87	$3,735.93	$5,677.77
Prevea360 Facility/Professional Professional Modifier Low / Median / High Price $2,826.92 / $4,818.83 / $5,924.63	Professional		$2,826.92	$4,818.83	$5,924.63
Quartz Facility/Professional Professional Modifier Low / Median / High Price $4,937.18 / $7,598.17 / $13,205.68	Professional		$4,937.18	$7,598.17	$13,205.68
Quartz Facility/Professional Facility Modifier Low / Median / High Price $2,756.64 / $9,642.94 / $22,996.26	Facility		$2,756.64	$9,642.94	$22,996.26
Quartz Facility/Professional Professional Modifier Low / Median / High Price $2,012.35 / $2,756.64 / $24,906.67	Professional		$2,012.35	$2,756.64	$24,906.67
Security Health Facility/Professional Professional Modifier Low / Median / High Price $4,937.18 / $4,937.18 / $4,937.18	Professional		$4,937.18	$4,937.18	$4,937.18
Security Health Facility/Professional Professional Modifier Low / Median / High Price $4,937.18 / $4,937.18 / $4,937.18	Professional		$4,937.18	$4,937.18	$4,937.18
United Facility/Professional Professional Modifier Low / Median / High Price $1,723.29 / $2,463.11 / $4,377.39	Professional		$1,723.29	$2,463.11	$4,377.39