Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $1,661.54 / $1,661.54 / $1,661.54	Facility		$1,661.54	$1,661.54	$1,661.54
Aetna Facility/Professional Professional Modifier Low / Median / High Price $1,203.19 / $1,661.54 / $2,758.78	Professional		$1,203.19	$1,661.54	$2,758.78
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $3,293.69 / $3,623.06 / $5,994.52	Facility		$3,293.69	$3,623.06	$5,994.52
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $3,063.13 / $3,063.13 / $4,051.23	Professional		$3,063.13	$3,063.13	$4,051.23
CareSource Facility/Professional Facility Modifier Low / Median / High Price $2,369.46 / $7,048.50 / $7,048.50	Facility		$2,369.46	$7,048.50	$7,048.50
Cigna Facility/Professional Facility Modifier Low / Median / High Price $1,743.07 / $6,809.52 / $13,747.92	Facility		$1,743.07	$6,809.52	$13,747.92
Cigna Facility/Professional Professional Modifier Low / Median / High Price $1,272.44 / $5,485.54 / $6,233.56	Professional		$1,272.44	$5,485.54	$6,233.56
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $898.44 / $2,492.31 / $3,787.74	Facility		$898.44	$2,492.31	$3,787.74
DeanCare Facility/Professional Professional Modifier Low / Median / High Price $1,885.89 / $3,226.81 / $3,952.43	Professional		$1,885.89	$3,226.81	$3,952.43
Medica Facility/Professional Facility Modifier Low / Median / High Price $1,555.24 / $3,293.69 / $14,630.94	Facility		$1,555.24	$3,293.69	$14,630.94
Medica Facility/Professional Professional Modifier Low / Median / High Price $1,483.65 / $2,096.37 / $3,586.42	Professional		$1,483.65	$2,096.37	$3,586.42
Molina Facility/Professional Professional Modifier Low / Median / High Price $50.00 / $70.00 / $2,017.12	Professional		$50.00	$70.00	$2,017.12
Prevea360 Facility/Professional Facility Modifier Low / Median / High Price $898.44 / $2,492.31 / $3,787.74	Facility		$898.44	$2,492.31	$3,787.74
Prevea360 Facility/Professional Professional Modifier Low / Median / High Price $1,885.89 / $3,226.81 / $3,952.43	Professional		$1,885.89	$3,226.81	$3,952.43
Quartz Facility/Professional Professional Modifier Low / Median / High Price $3,293.69 / $5,068.87 / $8,350.78	Professional		$3,293.69	$5,068.87	$8,350.78
Quartz Facility/Professional Facility Modifier Low / Median / High Price $1,743.07 / $6,432.98 / $14,630.94	Facility		$1,743.07	$6,432.98	$14,630.94
Quartz Facility/Professional Professional Modifier Low / Median / High Price $1,272.44 / $1,743.08 / $16,888.66	Professional		$1,272.44	$1,743.08	$16,888.66
Security Health Facility/Professional Professional Modifier Low / Median / High Price $3,293.69 / $3,293.69 / $3,293.69	Professional		$3,293.69	$3,293.69	$3,293.69
Security Health Facility/Professional Professional Modifier Low / Median / High Price $3,293.69 / $3,293.69 / $3,293.69	Professional		$3,293.69	$3,293.69	$3,293.69
United Facility/Professional Professional Modifier Low / Median / High Price $1,159.73 / $2,019.38 / $2,920.23	Professional		$1,159.73	$2,019.38	$2,920.23