Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $1,178.04 / $1,178.04 / $1,178.04	Facility		$1,178.04	$1,178.04	$1,178.04
Aetna Facility/Professional Professional Modifier Low / Median / High Price $847.89 / $1,178.04 / $1,955.99	Professional		$847.89	$1,178.04	$1,955.99
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $2,335.23 / $2,568.76 / $4,250.14	Facility		$2,335.23	$2,568.76	$4,250.14
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $2,101.71 / $2,171.77 / $2,872.34	Professional		$2,101.71	$2,171.77	$2,872.34
CareSource Facility/Professional Facility Modifier Low / Median / High Price $1,679.97 / $4,997.41 / $4,997.41	Facility		$1,679.97	$4,997.41	$4,997.41
Cigna Facility/Professional Facility Modifier Low / Median / High Price $1,271.83 / $4,828.31 / $9,747.95	Facility		$1,271.83	$4,828.31	$9,747.95
Cigna Facility/Professional Professional Modifier Low / Median / High Price $928.44 / $3,383.91 / $4,419.63	Professional		$928.44	$3,383.91	$4,419.63
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $655.54 / $1,767.06 / $2,685.53	Facility		$655.54	$1,767.06	$2,685.53
DeanCare Facility/Professional Professional Modifier Low / Median / High Price $1,337.09 / $2,335.23 / $2,802.29	Professional		$1,337.09	$2,335.23	$2,802.29
Medica Facility/Professional Facility Modifier Low / Median / High Price $1,134.77 / $2,335.23 / $11,043.30	Facility		$1,134.77	$2,335.23	$11,043.30
Medica Facility/Professional Professional Modifier Low / Median / High Price $1,051.91 / $1,529.60 / $2,542.79	Professional		$1,051.91	$1,529.60	$2,542.79
Molina Facility/Professional Professional Modifier Low / Median / High Price $50.00 / $70.00 / $1,373.58	Professional		$50.00	$70.00	$1,373.58
Prevea360 Facility/Professional Facility Modifier Low / Median / High Price $655.54 / $1,767.06 / $2,685.53	Facility		$655.54	$1,767.06	$2,685.53
Prevea360 Facility/Professional Professional Modifier Low / Median / High Price $1,337.09 / $2,335.23 / $2,802.29	Professional		$1,337.09	$2,335.23	$2,802.29
Quartz Facility/Professional Professional Modifier Low / Median / High Price $2,335.23 / $3,593.85 / $6,092.46	Professional		$2,335.23	$3,593.85	$6,092.46
Quartz Facility/Professional Facility Modifier Low / Median / High Price $1,271.83 / $4,561.02 / $11,043.30	Facility		$1,271.83	$4,561.02	$11,043.30
Quartz Facility/Professional Professional Modifier Low / Median / High Price $928.44 / $1,271.83 / $14,318.42	Professional		$928.44	$1,271.83	$14,318.42
Security Health Facility/Professional Professional Modifier Low / Median / High Price $2,335.23 / $2,335.23 / $2,335.23	Professional		$2,335.23	$2,335.23	$2,335.23
Security Health Facility/Professional Professional Modifier Low / Median / High Price $2,335.23 / $2,335.23 / $2,335.23	Professional		$2,335.23	$2,335.23	$2,335.23
United Facility/Professional Professional Modifier Low / Median / High Price $846.19 / $1,456.76 / $2,335.23	Professional		$846.19	$1,456.76	$2,335.23