Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $2,057.00 / $2,057.00 / $2,057.00	Facility		$2,057.00	$2,057.00	$2,057.00
Aetna Facility/Professional Professional Modifier Low / Median / High Price $1,380.97 / $2,057.00 / $3,415.39	Professional		$1,380.97	$2,057.00	$3,415.39
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $4,077.61 / $4,485.37 / $7,421.25	Facility		$4,077.61	$4,485.37	$7,421.25
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $3,669.84 / $3,792.18 / $5,015.46	Professional		$3,669.84	$3,792.18	$5,015.46
CareSource Facility/Professional Facility Modifier Low / Median / High Price $2,933.43 / $8,726.09 / $8,726.09	Facility		$2,933.43	$8,726.09	$8,726.09
Cigna Facility/Professional Facility Modifier Low / Median / High Price $2,637.76 / $8,430.54 / $17,020.09	Facility		$2,637.76	$8,430.54	$17,020.09
Cigna Facility/Professional Professional Modifier Low / Median / High Price $1,925.56 / $5,909.06 / $7,717.19	Professional		$1,925.56	$5,909.06	$7,717.19
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $1,067.70 / $3,085.50 / $4,689.25	Facility		$1,067.70	$3,085.50	$4,689.25
DeanCare Facility/Professional Professional Modifier Low / Median / High Price $2,334.73 / $4,077.61 / $4,893.13	Professional		$2,334.73	$4,077.61	$4,893.13
Medica Facility/Professional Facility Modifier Low / Median / High Price $1,848.23 / $4,077.61 / $17,548.22	Facility		$1,848.23	$4,077.61	$17,548.22
Medica Facility/Professional Professional Modifier Low / Median / High Price $1,825.15 / $2,491.30 / $4,440.01	Professional		$1,825.15	$2,491.30	$4,440.01
Molina Facility/Professional Professional Modifier Low / Median / High Price $50.00 / $70.00 / $2,237.19	Professional		$50.00	$70.00	$2,237.19
Prevea360 Facility/Professional Facility Modifier Low / Median / High Price $1,067.70 / $3,085.50 / $4,689.25	Facility		$1,067.70	$3,085.50	$4,689.25
Prevea360 Facility/Professional Professional Modifier Low / Median / High Price $2,334.73 / $4,077.61 / $4,893.13	Professional		$2,334.73	$4,077.61	$4,893.13
Quartz Facility/Professional Professional Modifier Low / Median / High Price $4,077.61 / $6,275.30 / $9,923.58	Professional		$4,077.61	$6,275.30	$9,923.58
Quartz Facility/Professional Facility Modifier Low / Median / High Price $2,637.76 / $7,964.08 / $17,548.22	Facility		$2,637.76	$7,964.08	$17,548.22
Quartz Facility/Professional Professional Modifier Low / Median / High Price $1,925.56 / $2,637.76 / $21,251.69	Professional		$1,925.56	$2,637.76	$21,251.69
Security Health Facility/Professional Professional Modifier Low / Median / High Price $4,077.61 / $4,077.61 / $4,077.61	Professional		$4,077.61	$4,077.61	$4,077.61
Security Health Facility/Professional Professional Modifier Low / Median / High Price $4,077.61 / $4,077.61 / $4,077.61	Professional		$4,077.61	$4,077.61	$4,077.61
United Facility/Professional Professional Modifier Low / Median / High Price $1,439.78 / $2,205.14 / $4,077.61	Professional		$1,439.78	$2,205.14	$4,077.61