Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $3,687.78 / $3,687.78 / $3,687.78	Facility		$3,687.78	$3,687.78	$3,687.78
Aetna Facility/Professional Professional Modifier Low / Median / High Price $2,562.92 / $3,687.78 / $6,123.10	Professional		$2,562.92	$3,687.78	$6,123.10
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $7,310.32 / $8,041.35 / $13,304.78	Facility		$7,310.32	$8,041.35	$13,304.78
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $6,798.60 / $6,798.60 / $8,991.69	Professional		$6,798.60	$6,798.60	$8,991.69
CareSource Facility/Professional Facility Modifier Low / Median / High Price $5,259.03 / $15,644.08 / $15,644.08	Facility		$5,259.03	$15,644.08	$15,644.08
Cigna Facility/Professional Facility Modifier Low / Median / High Price $4,728.96 / $15,113.42 / $30,513.29	Facility		$4,728.96	$15,113.42	$30,513.29
Cigna Facility/Professional Professional Modifier Low / Median / High Price $3,452.14 / $10,593.75 / $13,835.34	Professional		$3,452.14	$10,593.75	$13,835.34
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $1,968.27 / $5,531.67 / $8,406.87	Facility		$1,968.27	$5,531.67	$8,406.87
DeanCare Facility/Professional Professional Modifier Low / Median / High Price $4,185.70 / $7,310.32 / $8,772.37	Professional		$4,185.70	$7,310.32	$8,772.37
Medica Facility/Professional Facility Modifier Low / Median / High Price $3,407.15 / $7,310.32 / $34,402.54	Facility		$3,407.15	$7,310.32	$34,402.54
Medica Facility/Professional Professional Modifier Low / Median / High Price $3,292.95 / $4,592.63 / $7,960.03	Professional		$3,292.95	$4,592.63	$7,960.03
Molina Facility/Professional Professional Modifier Low / Median / High Price $50.00 / $70.00 / $4,124.18	Professional		$50.00	$70.00	$4,124.18
Prevea360 Facility/Professional Facility Modifier Low / Median / High Price $1,968.27 / $5,531.67 / $8,406.87	Facility		$1,968.27	$5,531.67	$8,406.87
Prevea360 Facility/Professional Professional Modifier Low / Median / High Price $4,185.70 / $7,310.32 / $8,772.37	Professional		$4,185.70	$7,310.32	$8,772.37
Quartz Facility/Professional Professional Modifier Low / Median / High Price $7,310.32 / $11,250.33 / $18,293.43	Professional		$7,310.32	$11,250.33	$18,293.43
Quartz Facility/Professional Facility Modifier Low / Median / High Price $4,728.96 / $14,277.96 / $34,402.54	Facility		$4,728.96	$14,277.96	$34,402.54
Quartz Facility/Professional Professional Modifier Low / Median / High Price $3,452.14 / $4,728.96 / $52,107.80	Professional		$3,452.14	$4,728.96	$52,107.80
Security Health Facility/Professional Professional Modifier Low / Median / High Price $7,310.32 / $7,310.32 / $7,310.32	Professional		$7,310.32	$7,310.32	$7,310.32
Security Health Facility/Professional Professional Modifier Low / Median / High Price $7,310.32 / $7,310.32 / $7,310.32	Professional		$7,310.32	$7,310.32	$7,310.32
United Facility/Professional Facility Modifier Low / Median / High Price $9,777.96 / $9,777.96 / $9,777.96	Facility		$9,777.96	$9,777.96	$9,777.96
United Facility/Professional Professional Modifier Low / Median / High Price $2,755.58 / $4,386.18 / $7,310.32	Professional		$2,755.58	$4,386.18	$7,310.32