Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $1,234.74 / $1,234.74 / $1,234.74	Facility		$1,234.74	$1,234.74	$1,234.74
Aetna Facility/Professional Professional Modifier Low / Median / High Price $1,181.23 / $1,234.74 / $2,243.37	Professional		$1,181.23	$1,234.74	$2,243.37
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $2,447.64 / $2,692.40 / $4,454.70	Facility		$2,447.64	$2,692.40	$4,454.70
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $2,202.87 / $2,276.31 / $3,010.59	Professional		$2,202.87	$2,276.31	$3,010.59
CareSource Facility/Professional Facility Modifier Low / Median / High Price $1,760.83 / $5,237.95 / $5,237.95	Facility		$1,760.83	$5,237.95	$5,237.95
Cigna Facility/Professional Facility Modifier Low / Median / High Price $1,618.14 / $5,403.90 / $10,216.82	Facility		$1,618.14	$5,403.90	$10,216.82
Cigna Facility/Professional Professional Modifier Low / Median / High Price $1,181.24 / $3,603.78 / $4,632.34	Professional		$1,181.24	$3,603.78	$4,632.34
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $710.36 / $1,852.11 / $2,814.79	Facility		$710.36	$1,852.11	$2,814.79
DeanCare Facility/Professional Professional Modifier Low / Median / High Price $1,401.46 / $2,356.04 / $2,937.17	Professional		$1,401.46	$2,356.04	$2,937.17
Medica Facility/Professional Facility Modifier Low / Median / High Price $1,229.66 / $2,447.64 / $11,530.40	Facility		$1,229.66	$2,447.64	$11,530.40
Medica Facility/Professional Professional Modifier Low / Median / High Price $1,080.29 / $1,283.72 / $2,665.18	Professional		$1,080.29	$1,283.72	$2,665.18
Molina Facility/Professional Professional Modifier Low / Median / High Price $50.00 / $70.00 / $1,727.54	Professional		$50.00	$70.00	$1,727.54
Prevea360 Facility/Professional Facility Modifier Low / Median / High Price $710.36 / $1,852.11 / $2,814.79	Facility		$710.36	$1,852.11	$2,814.79
Prevea360 Facility/Professional Professional Modifier Low / Median / High Price $1,401.46 / $2,356.04 / $2,937.17	Professional		$1,401.46	$2,356.04	$2,937.17
Quartz Facility/Professional Professional Modifier Low / Median / High Price $2,447.64 / $3,766.84 / $6,602.34	Professional		$2,447.64	$3,766.84	$6,602.34
Quartz Facility/Professional Facility Modifier Low / Median / High Price $1,618.14 / $4,780.54 / $11,530.40	Facility		$1,618.14	$4,780.54	$11,530.40
Quartz Facility/Professional Professional Modifier Low / Median / High Price $1,181.24 / $1,618.14 / $12,624.95	Professional		$1,181.24	$1,618.14	$12,624.95
Security Health Facility/Professional Professional Modifier Low / Median / High Price $2,447.64 / $2,447.64 / $2,447.64	Professional		$2,447.64	$2,447.64	$2,447.64
Security Health Facility/Professional Professional Modifier Low / Median / High Price $2,447.64 / $2,447.64 / $2,447.64	Professional		$2,447.64	$2,447.64	$2,447.64
United Facility/Professional Professional Modifier Low / Median / High Price $916.95 / $1,271.69 / $2,170.12	Professional		$916.95	$1,271.69	$2,170.12