Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $1,007.94 / $1,007.94 / $1,007.94	Facility		$1,007.94	$1,007.94	$1,007.94
Aetna Facility/Professional Professional Modifier Low / Median / High Price $914.75 / $1,007.94 / $1,737.28	Professional		$914.75	$1,007.94	$1,737.28
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $1,998.06 / $2,197.87 / $3,636.47	Facility		$1,998.06	$2,197.87	$3,636.47
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $1,728.12 / $1,858.20 / $2,457.61	Professional		$1,728.12	$1,858.20	$2,457.61
CareSource Facility/Professional Facility Modifier Low / Median / High Price $1,437.40 / $4,275.85 / $4,275.85	Facility		$1,437.40	$4,275.85	$4,275.85
Cigna Facility/Professional Facility Modifier Low / Median / High Price $1,172.51 / $4,130.38 / $8,340.00	Facility		$1,172.51	$4,130.38	$8,340.00
Cigna Facility/Professional Professional Modifier Low / Median / High Price $855.93 / $2,895.47 / $3,781.49	Professional		$855.93	$2,895.47	$3,781.49
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $604.35 / $1,511.91 / $2,297.77	Facility		$604.35	$1,511.91	$2,297.77
DeanCare Facility/Professional Professional Modifier Low / Median / High Price $1,144.04 / $1,998.06 / $2,501.92	Professional		$1,144.04	$1,998.06	$2,501.92
Medica Facility/Professional Facility Modifier Low / Median / High Price $1,007.94 / $1,998.06 / $9,934.14	Facility		$1,007.94	$1,998.06	$9,934.14
Medica Facility/Professional Professional Modifier Low / Median / High Price $865.54 / $1,092.16 / $2,255.77	Professional		$865.54	$1,092.16	$2,255.77
Molina Facility/Professional Professional Modifier Low / Median / High Price $50.00 / $65.00 / $85.00	Professional		$50.00	$65.00	$85.00
Prevea360 Facility/Professional Facility Modifier Low / Median / High Price $604.35 / $1,511.91 / $2,297.77	Facility		$604.35	$1,511.91	$2,297.77
Prevea360 Facility/Professional Professional Modifier Low / Median / High Price $1,144.04 / $1,998.06 / $2,501.92	Professional		$1,144.04	$1,998.06	$2,501.92
Quartz Facility/Professional Professional Modifier Low / Median / High Price $1,998.06 / $3,074.94 / $5,616.71	Professional		$1,998.06	$3,074.94	$5,616.71
Quartz Facility/Professional Facility Modifier Low / Median / High Price $1,172.51 / $3,902.46 / $9,934.14	Facility		$1,172.51	$3,902.46	$9,934.14
Quartz Facility/Professional Professional Modifier Low / Median / High Price $855.93 / $1,172.51 / $12,009.26	Professional		$855.93	$1,172.51	$12,009.26
Security Health Facility/Professional Professional Modifier Low / Median / High Price $1,998.06 / $1,998.06 / $1,998.06	Professional		$1,998.06	$1,998.06	$1,998.06
Security Health Facility/Professional Professional Modifier Low / Median / High Price $1,595.40 / $1,998.06 / $1,998.06	Professional		$1,595.40	$1,998.06	$1,998.06
United Facility/Professional Professional Modifier Low / Median / High Price $796.00 / $1,039.30 / $1,998.06	Professional		$796.00	$1,039.30	$1,998.06