Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $2,344.79 / $2,344.79 / $2,344.79	Facility		$2,344.79	$2,344.79	$2,344.79
Aetna Facility/Professional Professional Modifier Low / Median / High Price $1,736.94 / $2,344.79 / $3,893.24	Professional		$1,736.94	$2,344.79	$3,893.24
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $4,648.10 / $5,112.92 / $8,459.56	Facility		$4,648.10	$5,112.92	$8,459.56
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $4,183.29 / $4,322.74 / $5,717.17	Professional		$4,183.29	$4,322.74	$5,717.17
CareSource Facility/Professional Facility Modifier Low / Median / High Price $3,343.84 / $9,946.95 / $9,946.95	Facility		$3,343.84	$9,946.95	$9,946.95
Cigna Facility/Professional Facility Modifier Low / Median / High Price $3,006.81 / $9,609.70 / $19,402.16	Facility		$3,006.81	$9,609.70	$19,402.16
Cigna Facility/Professional Professional Modifier Low / Median / High Price $2,194.96 / $6,735.94 / $8,796.91	Professional		$2,194.96	$6,735.94	$8,796.91
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $1,342.91 / $3,517.19 / $5,345.33	Facility		$1,342.91	$3,517.19	$5,345.33
DeanCare Facility/Professional Professional Modifier Low / Median / High Price $2,661.39 / $4,648.10 / $5,577.73	Professional		$2,661.39	$4,648.10	$5,577.73
Medica Facility/Professional Facility Modifier Low / Median / High Price $2,324.64 / $4,648.10 / $22,146.98	Facility		$2,324.64	$4,648.10	$22,146.98
Medica Facility/Professional Professional Modifier Low / Median / High Price $2,093.75 / $3,105.73 / $5,200.41	Professional		$2,093.75	$3,105.73	$5,200.41
Molina Facility/Professional Professional Modifier Low / Median / High Price $50.00 / $70.00 / $2,813.86	Professional		$50.00	$70.00	$2,813.86
Prevea360 Facility/Professional Facility Modifier Low / Median / High Price $1,342.91 / $3,517.19 / $5,345.33	Facility		$1,342.91	$3,517.19	$5,345.33
Prevea360 Facility/Professional Professional Modifier Low / Median / High Price $2,661.39 / $4,648.10 / $5,577.73	Professional		$2,661.39	$4,648.10	$5,577.73
Quartz Facility/Professional Professional Modifier Low / Median / High Price $4,648.10 / $7,153.29 / $12,481.01	Professional		$4,648.10	$7,153.29	$12,481.01
Quartz Facility/Professional Facility Modifier Low / Median / High Price $3,006.81 / $9,078.34 / $22,146.98	Facility		$3,006.81	$9,078.34	$22,146.98
Quartz Facility/Professional Professional Modifier Low / Median / High Price $2,194.96 / $3,006.81 / $27,149.58	Professional		$2,194.96	$3,006.81	$27,149.58
Security Health Facility/Professional Professional Modifier Low / Median / High Price $4,648.10 / $4,648.10 / $4,648.10	Professional		$4,648.10	$4,648.10	$4,648.10
Security Health Facility/Professional Professional Modifier Low / Median / High Price $4,648.10 / $4,648.10 / $4,648.10	Professional		$4,648.10	$4,648.10	$4,648.10
United Facility/Professional Professional Modifier Low / Median / High Price $1,851.75 / $2,788.87 / $4,648.10	Professional		$1,851.75	$2,788.87	$4,648.10