Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $2,904.00 / $2,904.00 / $2,904.00	Facility		$2,904.00	$2,904.00	$2,904.00
Aetna Facility/Professional Professional Modifier Low / Median / High Price $1,902.04 / $2,904.00 / $4,821.74	Professional		$1,902.04	$2,904.00	$4,821.74
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $5,756.63 / $6,332.29 / $10,477.07	Facility		$5,756.63	$6,332.29	$10,477.07
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $5,180.96 / $5,353.67 / $7,080.65	Professional		$5,180.96	$5,353.67	$7,080.65
CareSource Facility/Professional Facility Modifier Low / Median / High Price $4,141.31 / $12,319.19 / $12,319.19	Facility		$4,141.31	$12,319.19	$12,319.19
Cigna Facility/Professional Facility Modifier Low / Median / High Price $2,853.06 / $11,901.44 / $24,029.11	Facility		$2,853.06	$11,901.44	$24,029.11
Cigna Facility/Professional Professional Modifier Low / Median / High Price $2,082.73 / $8,341.87 / $10,894.88	Professional		$2,082.73	$8,341.87	$10,894.88
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $1,470.57 / $4,356.00 / $6,620.12	Facility		$1,470.57	$4,356.00	$6,620.12
DeanCare Facility/Professional Professional Modifier Low / Median / High Price $3,296.13 / $5,756.63 / $6,907.96	Professional		$3,296.13	$5,756.63	$6,907.96
Medica Facility/Professional Facility Modifier Low / Median / High Price $2,545.61 / $5,756.63 / $24,371.76	Facility		$2,545.61	$5,756.63	$24,371.76
Medica Facility/Professional Professional Modifier Low / Median / High Price $2,430.79 / $3,432.08 / $6,268.26	Professional		$2,430.79	$3,432.08	$6,268.26
Molina Facility/Professional Professional Modifier Low / Median / High Price $50.00 / $70.00 / $3,163.36	Professional		$50.00	$70.00	$3,163.36
Prevea360 Facility/Professional Facility Modifier Low / Median / High Price $1,470.57 / $4,356.00 / $6,620.12	Facility		$1,470.57	$4,356.00	$6,620.12
Prevea360 Facility/Professional Professional Modifier Low / Median / High Price $3,296.13 / $5,756.63 / $6,907.96	Professional		$3,296.13	$5,756.63	$6,907.96
Quartz Facility/Professional Professional Modifier Low / Median / High Price $5,756.63 / $8,714.43 / $13,667.38	Professional		$5,756.63	$8,714.43	$13,667.38
Quartz Facility/Professional Facility Modifier Low / Median / High Price $2,853.06 / $11,243.42 / $24,371.76	Facility		$2,853.06	$11,243.42	$24,371.76
Quartz Facility/Professional Professional Modifier Low / Median / High Price $2,082.73 / $2,853.06 / $30,317.74	Professional		$2,082.73	$2,853.06	$30,317.74
Security Health Facility/Professional Professional Modifier Low / Median / High Price $5,756.63 / $5,756.63 / $5,756.63	Professional		$5,756.63	$5,756.63	$5,756.63
Security Health Facility/Professional Professional Modifier Low / Median / High Price $5,756.63 / $5,756.63 / $5,756.63	Professional		$5,756.63	$5,756.63	$5,756.63
United Facility/Professional Professional Modifier Low / Median / High Price $1,914.62 / $3,267.92 / $4,937.22	Professional		$1,914.62	$3,267.92	$4,937.22