Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $1,227.10 / $1,227.10 / $1,227.10	Facility		$1,227.10	$1,227.10	$1,227.10
Aetna Facility/Professional Professional Modifier Low / Median / High Price $834.42 / $1,227.10 / $2,037.47	Professional		$834.42	$1,227.10	$2,037.47
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $2,432.52 / $2,675.77 / $4,427.18	Facility		$2,432.52	$2,675.77	$4,427.18
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $2,262.23 / $2,262.23 / $2,991.99	Professional		$2,262.23	$2,262.23	$2,991.99
CareSource Facility/Professional Facility Modifier Low / Median / High Price $1,749.95 / $5,205.59 / $5,205.59	Facility		$1,749.95	$5,205.59	$5,205.59
Cigna Facility/Professional Facility Modifier Low / Median / High Price $1,573.58 / $5,029.05 / $10,153.84	Facility		$1,573.58	$5,029.05	$10,153.84
Cigna Facility/Professional Professional Modifier Low / Median / High Price $1,148.71 / $3,525.00 / $4,603.74	Professional		$1,148.71	$3,525.00	$4,603.74
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $587.59 / $1,840.67 / $2,797.40	Facility		$587.59	$1,840.67	$2,797.40
DeanCare Facility/Professional Professional Modifier Low / Median / High Price $1,392.81 / $2,432.52 / $2,919.02	Professional		$1,392.81	$2,432.52	$2,919.02
Medica Facility/Professional Facility Modifier Low / Median / High Price $1,017.14 / $2,421.51 / $9,671.83	Facility		$1,017.14	$2,421.51	$9,671.83
Medica Facility/Professional Professional Modifier Low / Median / High Price $1,051.91 / $1,371.34 / $2,648.71	Professional		$1,051.91	$1,371.34	$2,648.71
Molina Facility/Professional Professional Modifier Low / Median / High Price $50.00 / $70.00 / $1,231.20	Professional		$50.00	$70.00	$1,231.20
Prevea360 Facility/Professional Facility Modifier Low / Median / High Price $587.59 / $1,840.67 / $2,797.40	Facility		$587.59	$1,840.67	$2,797.40
Prevea360 Facility/Professional Professional Modifier Low / Median / High Price $1,392.81 / $2,432.52 / $2,919.02	Professional		$1,392.81	$2,432.52	$2,919.02
Quartz Facility/Professional Professional Modifier Low / Median / High Price $2,432.52 / $3,648.78 / $5,461.13	Professional		$2,432.52	$3,648.78	$5,461.13
Quartz Facility/Professional Facility Modifier Low / Median / High Price $1,573.58 / $4,751.02 / $9,671.83	Facility		$1,573.58	$4,751.02	$9,671.83
Quartz Facility/Professional Professional Modifier Low / Median / High Price $1,148.71 / $1,573.58 / $11,676.10	Professional		$1,148.71	$1,573.58	$11,676.10
Security Health Facility/Professional Professional Modifier Low / Median / High Price $2,432.52 / $2,432.52 / $2,432.52	Professional		$2,432.52	$2,432.52	$2,432.52
Security Health Facility/Professional Professional Modifier Low / Median / High Price $2,432.52 / $2,432.52 / $2,432.52	Professional		$2,432.52	$2,432.52	$2,432.52
United Facility/Professional Facility Modifier Low / Median / High Price $1,261.08 / $1,261.08 / $1,261.08	Facility		$1,261.08	$1,261.08	$1,261.08
United Facility/Professional Professional Modifier Low / Median / High Price $869.96 / $1,295.06 / $2,086.27	Professional		$869.96	$1,295.06	$2,086.27