Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $1,041.57 / $1,041.57 / $1,041.57	Facility		$1,041.57	$1,041.57	$1,041.57
Aetna Facility/Professional Professional Modifier Low / Median / High Price $985.81 / $1,041.57 / $1,872.22	Professional		$985.81	$1,041.57	$1,872.22
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $2,064.71 / $2,271.17 / $3,757.77	Facility		$2,064.71	$2,271.17	$3,757.77
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $1,898.64 / $1,920.18 / $2,539.59	Professional		$1,898.64	$1,920.18	$2,539.59
CareSource Facility/Professional Facility Modifier Low / Median / High Price $1,485.35 / $4,418.47 / $4,418.47	Facility		$1,485.35	$4,418.47	$4,418.47
Cigna Facility/Professional Facility Modifier Low / Median / High Price $1,335.63 / $4,558.35 / $8,618.52	Facility		$1,335.63	$4,558.35	$8,618.52
Cigna Facility/Professional Professional Modifier Low / Median / High Price $975.01 / $3,039.90 / $3,907.63	Professional		$975.01	$3,039.90	$3,907.63
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $594.04 / $1,562.36 / $2,374.42	Facility		$594.04	$1,562.36	$2,374.42
DeanCare Facility/Professional Professional Modifier Low / Median / High Price $1,182.20 / $2,015.23 / $2,477.65	Professional		$1,182.20	$2,015.23	$2,477.65
Medica Facility/Professional Facility Modifier Low / Median / High Price $1,028.32 / $2,064.71 / $9,614.69	Facility		$1,028.32	$2,064.71	$9,614.69
Medica Facility/Professional Professional Modifier Low / Median / High Price $901.57 / $1,081.57 / $2,248.21	Professional		$901.57	$1,081.57	$2,248.21
Molina Facility/Professional Professional Modifier Low / Median / High Price $50.00 / $70.00 / $1,361.17	Professional		$50.00	$70.00	$1,361.17
Prevea360 Facility/Professional Facility Modifier Low / Median / High Price $594.04 / $1,562.36 / $2,374.42	Facility		$594.04	$1,562.36	$2,374.42
Prevea360 Facility/Professional Professional Modifier Low / Median / High Price $1,182.20 / $2,015.23 / $2,477.65	Professional		$1,182.20	$2,015.23	$2,477.65
Quartz Facility/Professional Professional Modifier Low / Median / High Price $2,064.71 / $3,177.54 / $5,521.35	Professional		$2,064.71	$3,177.54	$5,521.35
Quartz Facility/Professional Facility Modifier Low / Median / High Price $1,335.63 / $4,032.64 / $9,614.69	Facility		$1,335.63	$4,032.64	$9,614.69
Quartz Facility/Professional Professional Modifier Low / Median / High Price $975.01 / $1,335.63 / $10,394.85	Professional		$975.01	$1,335.63	$10,394.85
Security Health Facility/Professional Professional Modifier Low / Median / High Price $2,064.71 / $2,064.71 / $2,064.71	Professional		$2,064.71	$2,064.71	$2,064.71
Security Health Facility/Professional Professional Modifier Low / Median / High Price $2,064.71 / $2,064.71 / $2,064.71	Professional		$2,064.71	$2,064.71	$2,064.71
United Facility/Professional Professional Modifier Low / Median / High Price $720.49 / $1,030.06 / $2,064.71	Professional		$720.49	$1,030.06	$2,064.71