Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $3,793.86 / $3,793.86 / $3,793.86	Facility		$3,793.86	$3,793.86	$3,793.86
Aetna Facility/Professional Professional Modifier Low / Median / High Price $2,582.69 / $3,793.86 / $6,299.24	Professional		$2,582.69	$3,793.86	$6,299.24
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $7,520.60 / $8,272.66 / $13,687.49	Facility		$7,520.60	$8,272.66	$13,687.49
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $6,819.87 / $6,994.16 / $9,250.33	Professional		$6,819.87	$6,994.16	$9,250.33
CareSource Facility/Professional Facility Modifier Low / Median / High Price $5,410.31 / $16,094.08 / $16,094.08	Facility		$5,410.31	$16,094.08	$16,094.08
Cigna Facility/Professional Facility Modifier Low / Median / High Price $4,865.01 / $15,547.75 / $31,392.22	Facility		$4,865.01	$15,547.75	$31,392.22
Cigna Facility/Professional Professional Modifier Low / Median / High Price $3,551.46 / $10,898.44 / $14,233.33	Professional		$3,551.46	$10,898.44	$14,233.33
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $1,988.15 / $5,690.79 / $8,648.69	Facility		$1,988.15	$5,690.79	$8,648.69
DeanCare Facility/Professional Professional Modifier Low / Median / High Price $4,306.13 / $7,520.60 / $9,024.71	Professional		$4,306.13	$7,520.60	$9,024.71
Medica Facility/Professional Facility Modifier Low / Median / High Price $3,441.57 / $7,520.60 / $33,007.53	Facility		$3,441.57	$7,520.60	$33,007.53
Medica Facility/Professional Professional Modifier Low / Median / High Price $3,387.68 / $4,639.02 / $8,189.02	Professional		$3,387.68	$4,639.02	$8,189.02
Molina Facility/Professional Professional Modifier Low / Median / High Price $50.00 / $70.00 / $4,207.28	Professional		$50.00	$70.00	$4,207.28
Prevea360 Facility/Professional Facility Modifier Low / Median / High Price $1,988.15 / $5,690.79 / $8,648.69	Facility		$1,988.15	$5,690.79	$8,648.69
Prevea360 Facility/Professional Professional Modifier Low / Median / High Price $4,306.13 / $7,520.60 / $9,024.71	Professional		$4,306.13	$7,520.60	$9,024.71
Quartz Facility/Professional Professional Modifier Low / Median / High Price $7,520.60 / $11,573.96 / $18,478.12	Professional		$7,520.60	$11,573.96	$18,478.12
Quartz Facility/Professional Facility Modifier Low / Median / High Price $4,865.01 / $14,688.68 / $33,007.53	Facility		$4,865.01	$14,688.68	$33,007.53
Quartz Facility/Professional Professional Modifier Low / Median / High Price $3,551.46 / $4,865.01 / $46,658.93	Professional		$3,551.46	$4,865.01	$46,658.93
Security Health Facility/Professional Professional Modifier Low / Median / High Price $7,520.60 / $7,520.60 / $7,520.60	Professional		$7,520.60	$7,520.60	$7,520.60
Security Health Facility/Professional Professional Modifier Low / Median / High Price $7,520.60 / $7,520.60 / $7,520.60	Professional		$7,520.60	$7,520.60	$7,520.60
United Facility/Professional Facility Modifier Low / Median / High Price $5,320.94 / $5,320.94 / $5,320.94	Facility		$5,320.94	$5,320.94	$5,320.94
United Facility/Professional Professional Modifier Low / Median / High Price $2,783.41 / $4,634.38 / $6,584.49	Professional		$2,783.41	$4,634.38	$6,584.49