Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $1,867.12 / $1,867.12 / $1,867.12	Facility		$1,867.12	$1,867.12	$1,867.12
Aetna Facility/Professional Professional Modifier Low / Median / High Price $1,794.41 / $1,867.12 / $3,545.55	Professional		$1,794.41	$1,867.12	$3,545.55
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $3,701.21 / $4,071.33 / $6,736.20	Facility		$3,701.21	$4,071.33	$6,736.20
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $3,331.08 / $3,442.13 / $4,552.47	Professional		$3,331.08	$3,442.13	$4,552.47
CareSource Facility/Professional Facility Modifier Low / Median / High Price $2,662.64 / $7,920.59 / $7,920.59	Facility		$2,662.64	$7,920.59	$7,920.59
Cigna Facility/Professional Facility Modifier Low / Median / High Price $2,017.28 / $7,651.93 / $15,449.79	Facility		$2,017.28	$7,651.93	$15,449.79
Cigna Facility/Professional Professional Modifier Low / Median / High Price $1,472.61 / $5,363.44 / $7,004.83	Professional		$1,472.61	$5,363.44	$7,004.83
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $1,039.78 / $2,800.68 / $4,256.39	Facility		$1,039.78	$2,800.68	$4,256.39
DeanCare Facility/Professional Professional Modifier Low / Median / High Price $2,119.23 / $3,701.21 / $4,441.45	Professional		$2,119.23	$3,701.21	$4,441.45
Medica Facility/Professional Facility Modifier Low / Median / High Price $1,799.90 / $3,701.21 / $17,217.72	Facility		$1,799.90	$3,701.21	$17,217.72
Medica Facility/Professional Professional Modifier Low / Median / High Price $1,489.14 / $1,915.81 / $4,030.16	Professional		$1,489.14	$1,915.81	$4,030.16
Molina Facility/Professional Professional Modifier Low / Median / High Price $50.00 / $70.00 / $1,998.17	Professional		$50.00	$70.00	$1,998.17
Prevea360 Facility/Professional Facility Modifier Low / Median / High Price $1,039.78 / $2,800.68 / $4,256.39	Facility		$1,039.78	$2,800.68	$4,256.39
Prevea360 Facility/Professional Professional Modifier Low / Median / High Price $2,119.23 / $3,701.21 / $4,441.45	Professional		$2,119.23	$3,701.21	$4,441.45
Quartz Facility/Professional Professional Modifier Low / Median / High Price $3,701.21 / $5,696.04 / $9,663.62	Professional		$3,701.21	$5,696.04	$9,663.62
Quartz Facility/Professional Facility Modifier Low / Median / High Price $2,017.28 / $7,228.92 / $17,217.72	Facility		$2,017.28	$7,228.92	$17,217.72
Quartz Facility/Professional Professional Modifier Low / Median / High Price $1,472.61 / $2,017.28 / $25,718.94	Professional		$1,472.61	$2,017.28	$25,718.94
Security Health Facility/Professional Professional Modifier Low / Median / High Price $3,701.21 / $3,701.21 / $3,701.21	Professional		$3,701.21	$3,701.21	$3,701.21
Security Health Facility/Professional Professional Modifier Low / Median / High Price $3,701.21 / $3,701.21 / $3,701.21	Professional		$3,701.21	$3,701.21	$3,701.21
United Facility/Professional Professional Modifier Low / Median / High Price $1,342.17 / $1,846.49 / $3,539.11	Professional		$1,342.17	$1,846.49	$3,539.11