Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $2,005.53 / $2,005.53 / $2,005.53	Facility		$2,005.53	$2,005.53	$2,005.53
Aetna Facility/Professional Professional Modifier Low / Median / High Price $1,451.50 / $2,005.53 / $3,329.94	Professional		$1,451.50	$2,005.53	$3,329.94
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $3,975.58 / $4,373.14 / $7,235.56	Facility		$3,975.58	$4,373.14	$7,235.56
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $3,438.47 / $3,697.29 / $4,889.96	Professional		$3,438.47	$3,697.29	$4,889.96
CareSource Facility/Professional Facility Modifier Low / Median / High Price $2,860.03 / $8,507.74 / $8,507.74	Facility		$2,860.03	$8,507.74	$8,507.74
Cigna Facility/Professional Facility Modifier Low / Median / High Price $2,571.77 / $8,219.45 / $16,594.63	Facility		$2,571.77	$8,219.45	$16,594.63
Cigna Facility/Professional Professional Modifier Low / Median / High Price $1,877.39 / $5,760.94 / $7,524.09	Professional		$1,877.39	$5,760.94	$7,524.09
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $989.06 / $3,008.30 / $4,571.92	Facility		$989.06	$3,008.30	$4,571.92
DeanCare Facility/Professional Professional Modifier Low / Median / High Price $2,276.33 / $3,325.18 / $4,770.70	Professional		$2,276.33	$3,325.18	$4,770.70
Medica Facility/Professional Facility Modifier Low / Median / High Price $1,712.10 / $3,975.58 / $16,090.64	Facility		$1,712.10	$3,975.58	$16,090.64
Medica Facility/Professional Professional Modifier Low / Median / High Price $1,664.91 / $2,308.31 / $4,328.92	Professional		$1,664.91	$2,308.31	$4,328.92
Molina Facility/Professional Professional Modifier Low / Median / High Price $50.00 / $70.00 / $2,072.41	Professional		$50.00	$70.00	$2,072.41
Prevea360 Facility/Professional Facility Modifier Low / Median / High Price $989.06 / $3,008.30 / $4,571.92	Facility		$989.06	$3,008.30	$4,571.92
Prevea360 Facility/Professional Professional Modifier Low / Median / High Price $2,276.33 / $3,325.18 / $4,770.70	Professional		$2,276.33	$3,325.18	$4,770.70
Quartz Facility/Professional Professional Modifier Low / Median / High Price $3,975.58 / $5,963.37 / $9,192.89	Professional		$3,975.58	$5,963.37	$9,192.89
Quartz Facility/Professional Facility Modifier Low / Median / High Price $2,571.77 / $7,764.80 / $16,090.64	Facility		$2,571.77	$7,764.80	$16,090.64
Quartz Facility/Professional Professional Modifier Low / Median / High Price $1,877.39 / $2,571.77 / $17,470.80	Professional		$1,877.39	$2,571.77	$17,470.80
Security Health Facility/Professional Professional Modifier Low / Median / High Price $3,975.58 / $3,975.58 / $3,975.58	Professional		$3,975.58	$3,975.58	$3,975.58
Security Health Facility/Professional Professional Modifier Low / Median / High Price $3,975.58 / $3,975.58 / $3,975.58	Professional		$3,975.58	$3,975.58	$3,975.58
United Facility/Professional Professional Modifier Low / Median / High Price $1,532.03 / $1,983.38 / $3,830.09	Professional		$1,532.03	$1,983.38	$3,830.09