Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $3,387.29 / $3,387.29 / $3,387.29	Facility		$3,387.29	$3,387.29	$3,387.29
Aetna Facility/Professional Professional Modifier Low / Median / High Price $2,644.37 / $3,387.29 / $5,624.18	Professional		$2,644.37	$3,387.29	$5,624.18
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $6,714.65 / $7,386.12 / $12,220.66	Facility		$6,714.65	$7,386.12	$12,220.66
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $6,043.18 / $6,244.62 / $8,259.01	Professional		$6,043.18	$6,244.62	$8,259.01
CareSource Facility/Professional Facility Modifier Low / Median / High Price $4,830.50 / $14,369.35 / $14,369.35	Facility		$4,830.50	$14,369.35	$14,369.35
Cigna Facility/Professional Facility Modifier Low / Median / High Price $3,790.37 / $14,825.13 / $28,027.67	Facility		$3,790.37	$14,825.13	$28,027.67
Cigna Facility/Professional Professional Modifier Low / Median / High Price $2,766.97 / $9,730.31 / $12,708.01	Professional		$2,766.97	$9,730.31	$12,708.01
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $1,953.69 / $5,080.93 / $7,721.85	Facility		$1,953.69	$5,080.93	$7,721.85
DeanCare Facility/Professional Professional Modifier Low / Median / High Price $3,844.66 / $6,714.65 / $8,087.97	Professional		$3,844.66	$6,714.65	$8,087.97
Medica Facility/Professional Facility Modifier Low / Median / High Price $3,381.92 / $6,714.65 / $32,412.74	Facility		$3,381.92	$6,714.65	$32,412.74
Medica Facility/Professional Professional Modifier Low / Median / High Price $3,066.89 / $4,486.55 / $7,565.63	Professional		$3,066.89	$4,486.55	$7,565.63
Molina Facility/Professional Professional Modifier Low / Median / High Price $50.00 / $70.00 / $4,531.42	Professional		$50.00	$70.00	$4,531.42
Prevea360 Facility/Professional Facility Modifier Low / Median / High Price $1,953.69 / $5,080.93 / $7,721.85	Facility		$1,953.69	$5,080.93	$7,721.85
Prevea360 Facility/Professional Professional Modifier Low / Median / High Price $3,844.66 / $6,714.65 / $8,087.97	Professional		$3,844.66	$6,714.65	$8,087.97
Quartz Facility/Professional Professional Modifier Low / Median / High Price $6,714.65 / $10,333.64 / $18,157.93	Professional		$6,714.65	$10,333.64	$18,157.93
Quartz Facility/Professional Facility Modifier Low / Median / High Price $3,790.37 / $13,114.56 / $32,412.74	Facility		$3,790.37	$13,114.56	$32,412.74
Quartz Facility/Professional Professional Modifier Low / Median / High Price $2,766.97 / $3,790.37 / $51,633.18	Professional		$2,766.97	$3,790.37	$51,633.18
Security Health Facility/Professional Professional Modifier Low / Median / High Price $6,714.65 / $6,714.65 / $6,714.65	Professional		$6,714.65	$6,714.65	$6,714.65
Security Health Facility/Professional Professional Modifier Low / Median / High Price $6,714.65 / $6,714.65 / $6,714.65	Professional		$6,714.65	$6,714.65	$6,714.65
United Facility/Professional Professional Modifier Low / Median / High Price $2,521.88 / $4,035.00 / $5,953.32	Professional		$2,521.88	$4,035.00	$5,953.32