Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $1,299.03 / $1,299.03 / $1,299.03	Facility		$1,299.03	$1,299.03	$1,299.03
Aetna Facility/Professional Professional Modifier Low / Median / High Price $918.93 / $1,299.03 / $1,789.23	Professional		$918.93	$1,299.03	$1,789.23
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $2,575.08 / $2,832.59 / $4,686.64	Facility		$2,575.08	$2,832.59	$4,686.64
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $2,155.33 / $2,394.82 / $3,167.34	Professional		$2,155.33	$2,394.82	$3,167.34
CareSource Facility/Professional Facility Modifier Low / Median / High Price $1,852.51 / $5,510.67 / $5,510.67	Facility		$1,852.51	$5,510.67	$5,510.67
Cigna Facility/Professional Facility Modifier Low / Median / High Price $1,206.80 / $5,323.62 / $10,748.65	Facility		$1,206.80	$5,323.62	$10,748.65
Cigna Facility/Professional Professional Modifier Low / Median / High Price $880.96 / $3,731.72 / $4,873.55	Professional		$880.96	$3,731.72	$4,873.55
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $622.02 / $1,948.55 / $2,961.34	Facility		$622.02	$1,948.55	$2,961.34
DeanCare Facility/Professional Professional Modifier Low / Median / High Price $1,474.42 / $1,931.31 / $3,090.10	Professional		$1,474.42	$1,931.31	$3,090.10
Medica Facility/Professional Facility Modifier Low / Median / High Price $1,076.74 / $2,575.08 / $10,169.41	Facility		$1,076.74	$2,575.08	$10,169.41
Medica Facility/Professional Professional Modifier Low / Median / High Price $954.91 / $1,284.68 / $2,803.94	Professional		$954.91	$1,284.68	$2,803.94
Molina Facility/Professional Professional Modifier Low / Median / High Price $50.00 / $70.00 / $1,175.98	Professional		$50.00	$70.00	$1,175.98
Prevea360 Facility/Professional Facility Modifier Low / Median / High Price $622.02 / $1,948.55 / $2,961.34	Facility		$622.02	$1,948.55	$2,961.34
Prevea360 Facility/Professional Professional Modifier Low / Median / High Price $1,474.42 / $1,931.31 / $3,090.10	Professional		$1,474.42	$1,931.31	$3,090.10
Quartz Facility/Professional Professional Modifier Low / Median / High Price $2,575.08 / $3,862.62 / $5,781.31	Professional		$2,575.08	$3,862.62	$5,781.31
Quartz Facility/Professional Facility Modifier Low / Median / High Price $1,206.80 / $5,029.46 / $10,169.41	Facility		$1,206.80	$5,029.46	$10,169.41
Quartz Facility/Professional Professional Modifier Low / Median / High Price $880.96 / $1,206.80 / $12,823.90	Professional		$880.96	$1,206.80	$12,823.90
Security Health Facility/Professional Professional Modifier Low / Median / High Price $2,575.08 / $2,575.08 / $2,575.08	Professional		$2,575.08	$2,575.08	$2,575.08
Security Health Facility/Professional Professional Modifier Low / Median / High Price $2,575.08 / $2,575.08 / $2,575.08	Professional		$2,575.08	$2,575.08	$2,575.08
United Facility/Professional Professional Modifier Low / Median / High Price $856.45 / $1,284.68 / $2,493.05	Professional		$856.45	$1,284.68	$2,493.05