Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $1,668.68 / $1,668.68 / $1,668.68	Facility		$1,668.68	$1,668.68	$1,668.68
Aetna Facility/Professional Professional Modifier Low / Median / High Price $1,200.53 / $1,668.68 / $2,770.64	Professional		$1,200.53	$1,668.68	$2,770.64
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $3,307.84 / $3,638.62 / $6,020.27	Facility		$3,307.84	$3,638.62	$6,020.27
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $3,076.29 / $3,076.29 / $4,068.64	Professional		$3,076.29	$3,076.29	$4,068.64
CareSource Facility/Professional Facility Modifier Low / Median / High Price $2,379.65 / $7,078.78 / $7,078.78	Facility		$2,379.65	$7,078.78	$7,078.78
Cigna Facility/Professional Facility Modifier Low / Median / High Price $2,084.13 / $6,838.61 / $13,806.70	Facility		$2,084.13	$6,838.61	$13,806.70
Cigna Facility/Professional Professional Modifier Low / Median / High Price $1,521.41 / $4,793.43 / $6,260.34	Professional		$1,521.41	$4,793.43	$6,260.34
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $887.16 / $2,503.02 / $3,804.02	Facility		$887.16	$2,503.02	$3,804.02
DeanCare Facility/Professional Professional Modifier Low / Median / High Price $1,894.00 / $3,195.81 / $3,969.41	Professional		$1,894.00	$3,195.81	$3,969.41
Medica Facility/Professional Facility Modifier Low / Median / High Price $1,535.70 / $3,307.84 / $14,469.30	Facility		$1,535.70	$3,307.84	$14,469.30
Medica Facility/Professional Professional Modifier Low / Median / High Price $1,392.65 / $2,070.03 / $3,601.83	Professional		$1,392.65	$2,070.03	$3,601.83
Molina Facility/Professional Professional Modifier Low / Median / High Price $50.00 / $70.00 / $1,858.89	Professional		$50.00	$70.00	$1,858.89
Prevea360 Facility/Professional Facility Modifier Low / Median / High Price $887.16 / $2,503.02 / $3,804.02	Facility		$887.16	$2,503.02	$3,804.02
Prevea360 Facility/Professional Professional Modifier Low / Median / High Price $1,894.00 / $3,195.81 / $3,969.41	Professional		$1,894.00	$3,195.81	$3,969.41
Quartz Facility/Professional Professional Modifier Low / Median / High Price $3,307.84 / $5,090.64 / $8,245.40	Professional		$3,307.84	$5,090.64	$8,245.40
Quartz Facility/Professional Facility Modifier Low / Median / High Price $2,084.13 / $6,460.62 / $14,469.30	Facility		$2,084.13	$6,460.62	$14,469.30
Quartz Facility/Professional Professional Modifier Low / Median / High Price $1,521.41 / $2,084.13 / $17,186.59	Professional		$1,521.41	$2,084.13	$17,186.59
Security Health Facility/Professional Professional Modifier Low / Median / High Price $3,307.84 / $3,307.84 / $3,307.84	Professional		$3,307.84	$3,307.84	$3,307.84
Security Health Facility/Professional Professional Modifier Low / Median / High Price $3,307.84 / $3,307.84 / $3,307.84	Professional		$3,307.84	$3,307.84	$3,307.84
United Facility/Professional Facility Modifier Low / Median / High Price $2.19 / $2,067.96 / $2,117.59	Facility		$2.19	$2,067.96	$2,117.59
United Facility/Professional Professional Modifier Low / Median / High Price $1,145.16 / $1,832.26 / $2,932.78	Professional		$1,145.16	$1,832.26	$2,932.78