Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $1,712.55 / $1,712.55 / $1,712.55	Facility		$1,712.55	$1,712.55	$1,712.55
Aetna Facility/Professional Professional Modifier Low / Median / High Price $1,179.45 / $1,712.55 / $2,843.48	Professional		$1,179.45	$1,712.55	$2,843.48
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $3,394.81 / $3,734.29 / $6,178.55	Facility		$3,394.81	$3,734.29	$6,178.55
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $3,055.32 / $3,157.17 / $4,175.60	Professional		$3,055.32	$3,157.17	$4,175.60
CareSource Facility/Professional Facility Modifier Low / Median / High Price $2,442.21 / $7,264.89 / $7,264.89	Facility		$2,442.21	$7,264.89	$7,264.89
Cigna Facility/Professional Facility Modifier Low / Median / High Price $1,769.18 / $7,018.72 / $14,170.59	Facility		$1,769.18	$7,018.72	$14,170.59
Cigna Facility/Professional Professional Modifier Low / Median / High Price $1,291.50 / $4,919.53 / $6,424.94	Professional		$1,291.50	$4,919.53	$6,424.94
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $911.89 / $2,568.83 / $3,904.03	Facility		$911.89	$2,568.83	$3,904.03
DeanCare Facility/Professional Professional Modifier Low / Median / High Price $1,943.77 / $3,394.81 / $4,073.77	Professional		$1,943.77	$3,394.81	$4,073.77
Medica Facility/Professional Facility Modifier Low / Median / High Price $1,578.52 / $3,394.81 / $14,790.81	Facility		$1,578.52	$3,394.81	$14,790.81
Medica Facility/Professional Professional Modifier Low / Median / High Price $1,529.19 / $2,127.75 / $3,696.53	Professional		$1,529.19	$2,127.75	$3,696.53
Molina Facility/Professional Professional Modifier Low / Median / High Price $50.00 / $70.00 / $1,910.72	Professional		$50.00	$70.00	$1,910.72
Prevea360 Facility/Professional Facility Modifier Low / Median / High Price $911.89 / $2,568.83 / $3,904.03	Facility		$911.89	$2,568.83	$3,904.03
Prevea360 Facility/Professional Professional Modifier Low / Median / High Price $1,943.77 / $3,394.81 / $4,073.77	Professional		$1,943.77	$3,394.81	$4,073.77
Quartz Facility/Professional Professional Modifier Low / Median / High Price $3,394.81 / $5,224.47 / $8,475.24	Professional		$3,394.81	$5,224.47	$8,475.24
Quartz Facility/Professional Facility Modifier Low / Median / High Price $1,769.18 / $6,630.48 / $14,790.81	Facility		$1,769.18	$6,630.48	$14,790.81
Quartz Facility/Professional Professional Modifier Low / Median / High Price $1,291.50 / $1,769.18 / $18,022.32	Professional		$1,291.50	$1,769.18	$18,022.32
Security Health Facility/Professional Professional Modifier Low / Median / High Price $3,394.81 / $3,394.81 / $3,394.81	Professional		$3,394.81	$3,394.81	$3,394.81
Security Health Facility/Professional Professional Modifier Low / Median / High Price $3,394.81 / $3,394.81 / $3,394.81	Professional		$3,394.81	$3,394.81	$3,394.81
United Facility/Professional Professional Modifier Low / Median / High Price $1,177.09 / $2,036.89 / $3,009.89	Professional		$1,177.09	$2,036.89	$3,009.89