Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $1,126.83 / $1,126.83 / $1,126.83	Facility		$1,126.83	$1,126.83	$1,126.83
Aetna Facility/Professional Professional Modifier Low / Median / High Price $992.62 / $1,148.09 / $1,885.15	Professional		$992.62	$1,148.09	$1,885.15
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $2,233.75 / $2,457.13 / $4,065.43	Facility		$2,233.75	$2,457.13	$4,065.43
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $2,010.37 / $2,077.39 / $2,747.51	Professional		$2,010.37	$2,077.39	$2,747.51
CareSource Facility/Professional Facility Modifier Low / Median / High Price $1,606.96 / $4,780.22 / $4,780.22	Facility		$1,606.96	$4,780.22	$4,780.22
Cigna Facility/Professional Facility Modifier Low / Median / High Price $1,306.07 / $4,618.16 / $9,323.90	Facility		$1,306.07	$4,618.16	$9,323.90
Cigna Facility/Professional Professional Modifier Low / Median / High Price $953.43 / $3,237.19 / $4,227.55	Professional		$953.43	$3,237.19	$4,227.55
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $673.20 / $1,690.26 / $2,568.81	Facility		$673.20	$1,690.26	$2,568.81
DeanCare Facility/Professional Professional Modifier Low / Median / High Price $1,278.99 / $2,233.75 / $2,680.50	Professional		$1,278.99	$2,233.75	$2,680.50
Medica Facility/Professional Facility Modifier Low / Median / High Price $1,126.83 / $2,280.27 / $11,140.65	Facility		$1,126.83	$2,280.27	$11,140.65
Medica Facility/Professional Professional Modifier Low / Median / High Price $964.13 / $1,216.57 / $2,499.10	Professional		$964.13	$1,216.57	$2,499.10
Molina Facility/Professional Professional Modifier Low / Median / High Price $50.00 / $70.00 / $1,017.63	Professional		$50.00	$70.00	$1,017.63
Prevea360 Facility/Professional Facility Modifier Low / Median / High Price $673.20 / $1,690.26 / $2,568.81	Facility		$673.20	$1,690.26	$2,568.81
Prevea360 Facility/Professional Professional Modifier Low / Median / High Price $1,278.99 / $2,233.75 / $2,680.50	Professional		$1,278.99	$2,233.75	$2,680.50
Quartz Facility/Professional Professional Modifier Low / Median / High Price $2,233.75 / $3,437.67 / $6,257.07	Professional		$2,233.75	$3,437.67	$6,257.07
Quartz Facility/Professional Facility Modifier Low / Median / High Price $1,306.07 / $4,362.80 / $11,140.65	Facility		$1,306.07	$4,362.80	$11,140.65
Quartz Facility/Professional Professional Modifier Low / Median / High Price $953.43 / $1,306.07 / $13,377.22	Professional		$953.43	$1,306.07	$13,377.22
Security Health Facility/Professional Professional Modifier Low / Median / High Price $2,233.75 / $2,233.75 / $2,233.75	Professional		$2,233.75	$2,233.75	$2,233.75
Security Health Facility/Professional Professional Modifier Low / Median / High Price $1,783.60 / $2,233.75 / $2,233.75	Professional		$1,783.60	$2,233.75	$2,233.75
United Facility/Professional Professional Modifier Low / Median / High Price $868.98 / $1,114.40 / $1,980.48	Professional		$868.98	$1,114.40	$1,980.48