Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $3,405.02 / $3,405.02 / $3,405.02	Facility		$3,405.02	$3,405.02	$3,405.02
Aetna Facility/Professional Professional Modifier Low / Median / High Price $2,594.21 / $3,405.02 / $5,653.62	Professional		$2,594.21	$3,405.02	$5,653.62
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $6,749.81 / $7,424.79 / $12,284.65	Facility		$6,749.81	$7,424.79	$12,284.65
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $6,074.82 / $6,277.32 / $8,302.26	Professional		$6,074.82	$6,277.32	$8,302.26
CareSource Facility/Professional Facility Modifier Low / Median / High Price $4,855.80 / $14,444.59 / $14,444.59	Facility		$4,855.80	$14,444.59	$14,444.59
Cigna Facility/Professional Facility Modifier Low / Median / High Price $4,366.38 / $13,954.89 / $28,174.62	Facility		$4,366.38	$13,954.89	$28,174.62
Cigna Facility/Professional Professional Modifier Low / Median / High Price $3,187.46 / $9,781.41 / $12,774.54	Professional		$3,187.46	$9,781.41	$12,774.54
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $2,005.72 / $5,107.53 / $7,762.28	Facility		$2,005.72	$5,107.53	$7,762.28
DeanCare Facility/Professional Professional Modifier Low / Median / High Price $3,864.78 / $6,749.81 / $8,303.35	Professional		$3,864.78	$6,749.81	$8,303.35
Medica Facility/Professional Facility Modifier Low / Median / High Price $3,405.02 / $6,749.81 / $33,390.44	Facility		$3,405.02	$6,749.81	$33,390.44
Medica Facility/Professional Professional Modifier Low / Median / High Price $3,138.35 / $4,510.04 / $7,620.43	Professional		$3,138.35	$4,510.04	$7,620.43
Molina Facility/Professional Professional Modifier Low / Median / High Price $50.00 / $70.00 / $4,202.66	Professional		$50.00	$70.00	$4,202.66
Prevea360 Facility/Professional Facility Modifier Low / Median / High Price $2,005.72 / $5,107.53 / $7,762.28	Facility		$2,005.72	$5,107.53	$7,762.28
Prevea360 Facility/Professional Professional Modifier Low / Median / High Price $3,864.78 / $6,749.81 / $8,303.35	Professional		$3,864.78	$6,749.81	$8,303.35
Quartz Facility/Professional Professional Modifier Low / Median / High Price $6,749.81 / $10,387.75 / $18,641.72	Professional		$6,749.81	$10,387.75	$18,641.72
Quartz Facility/Professional Facility Modifier Low / Median / High Price $4,366.38 / $13,183.22 / $33,390.44	Facility		$4,366.38	$13,183.22	$33,390.44
Quartz Facility/Professional Professional Modifier Low / Median / High Price $3,187.46 / $4,366.38 / $45,658.26	Professional		$3,187.46	$4,366.38	$45,658.26
Security Health Facility/Professional Professional Modifier Low / Median / High Price $6,749.81 / $6,749.81 / $6,749.81	Professional		$6,749.81	$6,749.81	$6,749.81
Security Health Facility/Professional Professional Modifier Low / Median / High Price $6,749.81 / $6,749.81 / $6,749.81	Professional		$6,749.81	$6,749.81	$6,749.81
United Facility/Professional Professional Modifier Low / Median / High Price $2,689.04 / $4,489.88 / $6,749.81	Professional		$2,689.04	$4,489.88	$6,749.81