Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $2,862.20 / $2,862.20 / $2,862.20	Facility		$2,862.20	$2,862.20	$2,862.20
Aetna Facility/Professional Professional Modifier Low / Median / High Price $1,909.75 / $2,862.20 / $4,752.33	Professional		$1,909.75	$2,862.20	$4,752.33
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $5,673.77 / $6,241.15 / $10,326.26	Facility		$5,673.77	$6,241.15	$10,326.26
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $5,042.88 / $5,276.61 / $6,978.73	Professional		$5,042.88	$5,276.61	$6,978.73
CareSource Facility/Professional Facility Modifier Low / Median / High Price $4,081.69 / $12,141.87 / $12,141.87	Facility		$4,081.69	$12,141.87	$12,141.87
Cigna Facility/Professional Facility Modifier Low / Median / High Price $3,670.30 / $11,729.77 / $23,683.42	Facility		$3,670.30	$11,729.77	$23,683.42
Cigna Facility/Professional Professional Modifier Low / Median / High Price $2,679.32 / $8,221.87 / $10,738.05	Professional		$2,679.32	$8,221.87	$10,738.05
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $1,476.53 / $4,293.30 / $6,524.84	Facility		$1,476.53	$4,293.30	$6,524.84
DeanCare Facility/Professional Professional Modifier Low / Median / High Price $3,248.66 / $5,673.77 / $6,808.52	Professional		$3,248.66	$5,673.77	$6,808.52
Medica Facility/Professional Facility Modifier Low / Median / High Price $2,555.92 / $5,673.77 / $24,492.50	Facility		$2,555.92	$5,673.77	$24,492.50
Medica Facility/Professional Professional Modifier Low / Median / High Price $2,555.77 / $3,445.23 / $6,178.03	Professional		$2,555.77	$3,445.23	$6,178.03
Molina Facility/Professional Professional Modifier Low / Median / High Price $50.00 / $70.00 / $1,755.66	Professional		$50.00	$70.00	$1,755.66
Prevea360 Facility/Professional Facility Modifier Low / Median / High Price $1,476.53 / $4,293.30 / $6,524.84	Facility		$1,476.53	$4,293.30	$6,524.84
Prevea360 Facility/Professional Professional Modifier Low / Median / High Price $3,248.66 / $5,673.77 / $6,808.52	Professional		$3,248.66	$5,673.77	$6,808.52
Quartz Facility/Professional Professional Modifier Low / Median / High Price $5,673.77 / $8,731.71 / $13,723.59	Professional		$5,673.77	$8,731.71	$13,723.59
Quartz Facility/Professional Facility Modifier Low / Median / High Price $3,670.30 / $11,081.58 / $24,492.50	Facility		$3,670.30	$11,081.58	$24,492.50
Quartz Facility/Professional Professional Modifier Low / Median / High Price $2,679.32 / $3,670.30 / $30,123.14	Professional		$2,679.32	$3,670.30	$30,123.14
Security Health Facility/Professional Professional Modifier Low / Median / High Price $5,673.77 / $5,673.77 / $5,673.77	Professional		$5,673.77	$5,673.77	$5,673.77
Security Health Facility/Professional Professional Modifier Low / Median / High Price $5,673.77 / $5,673.77 / $5,673.77	Professional		$5,673.77	$5,673.77	$5,673.77
United Facility/Professional Professional Modifier Low / Median / High Price $1,905.94 / $3,049.50 / $5,673.77	Professional		$1,905.94	$3,049.50	$5,673.77