Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $2,175.67 / $2,175.67 / $2,175.67	Facility		$2,175.67	$2,175.67	$2,175.67
Aetna Facility/Professional Professional Modifier Low / Median / High Price $1,993.57 / $2,175.67 / $4,022.85	Professional		$1,993.57	$2,175.67	$4,022.85
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $4,312.87 / $4,744.16 / $7,849.42	Facility		$4,312.87	$4,744.16	$7,849.42
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $4,010.97 / $4,010.97 / $5,304.83	Professional		$4,010.97	$4,010.97	$5,304.83
CareSource Facility/Professional Facility Modifier Low / Median / High Price $3,102.67 / $9,229.54 / $9,229.54	Facility		$3,102.67	$9,229.54	$9,229.54
Cigna Facility/Professional Facility Modifier Low / Median / High Price $2,481.10 / $9,522.44 / $18,002.59	Facility		$2,481.10	$9,522.44	$18,002.59
Cigna Facility/Professional Professional Modifier Low / Median / High Price $1,811.20 / $6,249.84 / $8,162.45	Professional		$1,811.20	$6,249.84	$8,162.45
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $1,270.53 / $3,263.52 / $4,959.80	Facility		$1,270.53	$3,263.52	$4,959.80
DeanCare Facility/Professional Professional Modifier Low / Median / High Price $2,469.44 / $4,312.87 / $5,259.79	Professional		$2,469.44	$4,312.87	$5,259.79
Medica Facility/Professional Facility Modifier Low / Median / High Price $2,175.67 / $4,312.87 / $20,983.29	Facility		$2,175.67	$4,312.87	$20,983.29
Medica Facility/Professional Professional Modifier Low / Median / High Price $1,968.04 / $2,881.74 / $4,869.14	Professional		$1,968.04	$2,881.74	$4,869.14
Molina Facility/Professional Professional Modifier Low / Median / High Price $50.00 / $70.00 / $2,910.56	Professional		$50.00	$70.00	$2,910.56
Prevea360 Facility/Professional Facility Modifier Low / Median / High Price $1,270.53 / $3,263.52 / $4,959.80	Facility		$1,270.53	$3,263.52	$4,959.80
Prevea360 Facility/Professional Professional Modifier Low / Median / High Price $2,469.44 / $4,312.87 / $5,259.79	Professional		$2,469.44	$4,312.87	$5,259.79
Quartz Facility/Professional Professional Modifier Low / Median / High Price $4,312.87 / $6,637.34 / $11,808.53	Professional		$4,312.87	$6,637.34	$11,808.53
Quartz Facility/Professional Facility Modifier Low / Median / High Price $2,481.10 / $8,423.58 / $20,983.29	Facility		$2,481.10	$8,423.58	$20,983.29
Quartz Facility/Professional Professional Modifier Low / Median / High Price $1,811.20 / $2,481.10 / $26,681.22	Professional		$1,811.20	$2,481.10	$26,681.22
Security Health Facility/Professional Professional Modifier Low / Median / High Price $4,312.87 / $4,312.87 / $4,312.87	Professional		$4,312.87	$4,312.87	$4,312.87
Security Health Facility/Professional Professional Modifier Low / Median / High Price $4,312.87 / $4,312.87 / $4,312.87	Professional		$4,312.87	$4,312.87	$4,312.87
United Facility/Professional Facility Modifier Low / Median / High Price $3.14 / $2,961.61 / $3,032.69	Facility		$3.14	$2,961.61	$3,032.69
United Facility/Professional Professional Modifier Low / Median / High Price $1,718.19 / $2,868.86 / $3,698.95	Professional		$1,718.19	$2,868.86	$3,698.95