Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $3,175.75 / $3,175.75 / $3,175.75	Facility		$3,175.75	$3,175.75	$3,175.75
Aetna Facility/Professional Professional Modifier Low / Median / High Price $2,282.54 / $3,175.75 / $5,272.94	Professional		$2,282.54	$3,175.75	$5,272.94
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $6,295.32 / $6,924.85 / $11,457.48	Facility		$6,295.32	$6,924.85	$11,457.48
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $5,854.65 / $5,854.65 / $7,743.24	Professional		$5,854.65	$5,854.65	$7,743.24
CareSource Facility/Professional Facility Modifier Low / Median / High Price $4,528.84 / $13,471.98 / $13,471.98	Facility		$4,528.84	$13,471.98	$13,471.98
Cigna Facility/Professional Facility Modifier Low / Median / High Price $4,072.36 / $13,014.94 / $26,276.81	Facility		$4,072.36	$13,014.94	$26,276.81
Cigna Facility/Professional Professional Modifier Low / Median / High Price $2,972.82 / $9,122.81 / $11,914.38	Professional		$2,972.82	$9,122.81	$11,914.38
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $1,718.86 / $4,763.63 / $7,239.62	Facility		$1,718.86	$4,763.63	$7,239.62
DeanCare Facility/Professional Professional Modifier Low / Median / High Price $3,604.54 / $6,295.32 / $7,554.38	Professional		$3,604.54	$6,295.32	$7,554.38
Medica Facility/Professional Facility Modifier Low / Median / High Price $2,975.41 / $6,295.32 / $28,628.31	Facility		$2,975.41	$6,295.32	$28,628.31
Medica Facility/Professional Professional Modifier Low / Median / High Price $2,698.25 / $4,010.66 / $6,854.83	Professional		$2,698.25	$4,010.66	$6,854.83
Molina Facility/Professional Professional Modifier Low / Median / High Price $50.00 / $70.00 / $3,601.58	Professional		$50.00	$70.00	$3,601.58
Prevea360 Facility/Professional Facility Modifier Low / Median / High Price $1,718.86 / $4,763.63 / $7,239.62	Facility		$1,718.86	$4,763.63	$7,239.62
Prevea360 Facility/Professional Professional Modifier Low / Median / High Price $3,604.54 / $6,295.32 / $7,554.38	Professional		$3,604.54	$6,295.32	$7,554.38
Quartz Facility/Professional Professional Modifier Low / Median / High Price $6,295.32 / $9,688.27 / $15,975.89	Professional		$6,295.32	$9,688.27	$15,975.89
Quartz Facility/Professional Facility Modifier Low / Median / High Price $4,072.36 / $12,295.54 / $28,628.31	Facility		$4,072.36	$12,295.54	$28,628.31
Quartz Facility/Professional Professional Modifier Low / Median / High Price $2,972.82 / $4,072.36 / $40,587.48	Professional		$2,972.82	$4,072.36	$40,587.48
Security Health Facility/Professional Professional Modifier Low / Median / High Price $6,295.32 / $6,295.32 / $6,295.32	Professional		$6,295.32	$6,295.32	$6,295.32
Security Health Facility/Professional Professional Modifier Low / Median / High Price $6,295.32 / $6,295.32 / $6,295.32	Professional		$6,295.32	$6,295.32	$6,295.32
United Facility/Professional Professional Modifier Low / Median / High Price $2,218.73 / $3,297.70 / $5,399.21	Professional		$2,218.73	$3,297.70	$5,399.21