Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $1,936.20 / $1,936.20 / $1,936.20	Facility		$1,936.20	$1,936.20	$1,936.20
Aetna Facility/Professional Professional Modifier Low / Median / High Price $1,379.09 / $1,936.20 / $3,214.82	Professional		$1,379.09	$1,936.20	$3,214.82
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $3,838.15 / $4,221.97 / $6,985.43	Facility		$3,838.15	$4,221.97	$6,985.43
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $3,454.33 / $3,569.48 / $4,720.92	Professional		$3,454.33	$3,569.48	$4,720.92
CareSource Facility/Professional Facility Modifier Low / Median / High Price $2,761.16 / $8,213.64 / $8,213.64	Facility		$2,761.16	$8,213.64	$8,213.64
Cigna Facility/Professional Facility Modifier Low / Median / High Price $2,482.86 / $7,935.24 / $16,020.81	Facility		$2,482.86	$7,935.24	$16,020.81
Cigna Facility/Professional Professional Modifier Low / Median / High Price $1,812.49 / $5,562.19 / $7,263.99	Professional		$1,812.49	$5,562.19	$7,263.99
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $1,066.25 / $2,904.30 / $4,413.87	Facility		$1,066.25	$2,904.30	$4,413.87
DeanCare Facility/Professional Professional Modifier Low / Median / High Price $2,197.63 / $3,838.15 / $4,605.78	Professional		$2,197.63	$3,838.15	$4,605.78
Medica Facility/Professional Facility Modifier Low / Median / High Price $1,845.71 / $3,838.15 / $17,674.86	Facility		$1,845.71	$3,838.15	$17,674.86
Medica Facility/Professional Professional Modifier Low / Median / High Price $1,728.91 / $2,487.91 / $4,179.27	Professional		$1,728.91	$2,487.91	$4,179.27
Molina Facility/Professional Professional Modifier Low / Median / High Price $50.00 / $70.00 / $2,234.15	Professional		$50.00	$70.00	$2,234.15
Prevea360 Facility/Professional Facility Modifier Low / Median / High Price $1,066.25 / $2,904.30 / $4,413.87	Facility		$1,066.25	$2,904.30	$4,413.87
Prevea360 Facility/Professional Professional Modifier Low / Median / High Price $2,197.63 / $3,838.15 / $4,605.78	Professional		$2,197.63	$3,838.15	$4,605.78
Quartz Facility/Professional Professional Modifier Low / Median / High Price $3,838.15 / $5,906.80 / $9,909.53	Professional		$3,838.15	$5,906.80	$9,909.53
Quartz Facility/Professional Facility Modifier Low / Median / High Price $2,482.86 / $7,496.38 / $17,674.86	Facility		$2,482.86	$7,496.38	$17,674.86
Quartz Facility/Professional Professional Modifier Low / Median / High Price $1,812.49 / $2,482.86 / $22,536.86	Professional		$1,812.49	$2,482.86	$22,536.86
Security Health Facility/Professional Professional Modifier Low / Median / High Price $3,838.15 / $3,838.15 / $3,838.15	Professional		$3,838.15	$3,838.15	$3,838.15
Security Health Facility/Professional Professional Modifier Low / Median / High Price $3,838.15 / $3,838.15 / $3,838.15	Professional		$3,838.15	$3,838.15	$3,838.15
United Facility/Professional Facility Modifier Low / Median / High Price $2.64 / $2,485.42 / $2,545.08	Facility		$2.64	$2,485.42	$2,545.08
United Facility/Professional Professional Modifier Low / Median / High Price $1,376.34 / $2,202.14 / $3,402.97	Professional		$1,376.34	$2,202.14	$3,402.97