Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $2,606.85 / $2,606.85 / $2,606.85	Facility		$2,606.85	$2,606.85	$2,606.85
Aetna Facility/Professional Professional Modifier Low / Median / High Price $1,755.80 / $2,606.85 / $4,328.35	Professional		$1,755.80	$2,606.85	$4,328.35
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $5,167.59 / $5,684.35 / $9,405.01	Facility		$5,167.59	$5,684.35	$9,405.01
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $4,650.83 / $4,805.85 / $6,356.13	Professional		$4,650.83	$4,805.85	$6,356.13
CareSource Facility/Professional Facility Modifier Low / Median / High Price $3,717.56 / $11,058.64 / $11,058.64	Facility		$3,717.56	$11,058.64	$11,058.64
Cigna Facility/Professional Facility Modifier Low / Median / High Price $3,249.00 / $10,683.81 / $21,570.08	Facility		$3,249.00	$10,683.81	$21,570.08
Cigna Facility/Professional Professional Modifier Low / Median / High Price $2,371.77 / $7,488.28 / $9,780.06	Professional		$2,371.77	$7,488.28	$9,780.06
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $1,357.50 / $3,910.28 / $5,942.73	Facility		$1,357.50	$3,910.28	$5,942.73
DeanCare Facility/Professional Professional Modifier Low / Median / High Price $2,958.84 / $5,167.59 / $6,201.11	Professional		$2,958.84	$5,167.59	$6,201.11
Medica Facility/Professional Facility Modifier Low / Median / High Price $2,349.89 / $5,167.59 / $22,345.83	Facility		$2,349.89	$5,167.59	$22,345.83
Medica Facility/Professional Professional Modifier Low / Median / High Price $2,327.76 / $3,167.50 / $5,626.87	Professional		$2,327.76	$3,167.50	$5,626.87
Molina Facility/Professional Professional Modifier Low / Median / High Price $50.00 / $70.00 / $2,844.42	Professional		$50.00	$70.00	$2,844.42
Prevea360 Facility/Professional Facility Modifier Low / Median / High Price $1,357.50 / $3,910.28 / $5,942.73	Facility		$1,357.50	$3,910.28	$5,942.73
Prevea360 Facility/Professional Professional Modifier Low / Median / High Price $2,958.84 / $5,167.59 / $6,201.11	Professional		$2,958.84	$5,167.59	$6,201.11
Quartz Facility/Professional Professional Modifier Low / Median / High Price $5,167.59 / $7,952.75 / $12,616.51	Professional		$5,167.59	$7,952.75	$12,616.51
Quartz Facility/Professional Facility Modifier Low / Median / High Price $3,249.00 / $10,092.94 / $22,345.83	Facility		$3,249.00	$10,092.94	$22,345.83
Quartz Facility/Professional Professional Modifier Low / Median / High Price $2,371.77 / $3,249.00 / $26,975.23	Professional		$2,371.77	$3,249.00	$26,975.23
Security Health Facility/Professional Professional Modifier Low / Median / High Price $5,167.59 / $5,167.59 / $5,167.59	Professional		$5,167.59	$5,167.59	$5,167.59
Security Health Facility/Professional Professional Modifier Low / Median / High Price $5,167.59 / $5,167.59 / $5,167.59	Professional		$5,167.59	$5,167.59	$5,167.59
United Facility/Professional Professional Modifier Low / Median / High Price $1,830.57 / $3,100.55 / $4,495.87	Professional		$1,830.57	$3,100.55	$4,495.87