Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $1,531.65 / $1,531.65 / $1,531.65	Facility		$1,531.65	$1,531.65	$1,531.65
Aetna Facility/Professional Professional Modifier Low / Median / High Price $1,035.17 / $1,531.65 / $2,543.11	Professional		$1,035.17	$1,531.65	$2,543.11
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $3,036.20 / $3,339.82 / $5,525.88	Facility		$3,036.20	$3,339.82	$5,525.88
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $2,732.58 / $2,823.67 / $3,734.52	Professional		$2,732.58	$2,823.67	$3,734.52
CareSource Facility/Professional Facility Modifier Low / Median / High Price $2,184.23 / $6,497.47 / $6,497.47	Facility		$2,184.23	$6,497.47	$6,497.47
Cigna Facility/Professional Facility Modifier Low / Median / High Price $1,552.76 / $6,276.70 / $12,673.05	Facility		$1,552.76	$6,276.70	$12,673.05
Cigna Facility/Professional Professional Modifier Low / Median / High Price $1,133.51 / $5,056.70 / $5,746.25	Professional		$1,133.51	$5,056.70	$5,746.25
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $800.34 / $2,297.48 / $3,491.63	Facility		$800.34	$2,297.48	$3,491.63
DeanCare Facility/Professional Professional Modifier Low / Median / High Price $1,738.45 / $2,941.17 / $3,643.44	Professional		$1,738.45	$2,941.17	$3,643.44
Medica Facility/Professional Facility Modifier Low / Median / High Price $1,385.42 / $3,036.20 / $13,558.52	Facility		$1,385.42	$3,036.20	$13,558.52
Medica Facility/Professional Professional Modifier Low / Median / High Price $1,367.66 / $1,867.47 / $3,306.05	Professional		$1,367.66	$1,867.47	$3,306.05
Molina Facility/Professional Professional Modifier Low / Median / High Price $50.00 / $70.00 / $1,212.61	Professional		$50.00	$70.00	$1,212.61
Prevea360 Facility/Professional Facility Modifier Low / Median / High Price $800.34 / $2,297.48 / $3,491.63	Facility		$800.34	$2,297.48	$3,491.63
Prevea360 Facility/Professional Professional Modifier Low / Median / High Price $1,738.45 / $2,941.17 / $3,643.44	Professional		$1,738.45	$2,941.17	$3,643.44
Quartz Facility/Professional Professional Modifier Low / Median / High Price $3,036.20 / $4,672.60 / $7,438.42	Professional		$3,036.20	$4,672.60	$7,438.42
Quartz Facility/Professional Facility Modifier Low / Median / High Price $1,552.76 / $5,930.08 / $13,558.52	Facility		$1,552.76	$5,930.08	$13,558.52
Quartz Facility/Professional Professional Modifier Low / Median / High Price $1,133.51 / $1,552.76 / $16,025.89	Professional		$1,133.51	$1,552.76	$16,025.89
Security Health Facility/Professional Professional Modifier Low / Median / High Price $3,036.20 / $3,036.20 / $3,036.20	Professional		$3,036.20	$3,036.20	$3,036.20
Security Health Facility/Professional Professional Modifier Low / Median / High Price $3,036.20 / $3,036.20 / $3,036.20	Professional		$3,036.20	$3,036.20	$3,036.20
United Facility/Professional Professional Modifier Low / Median / High Price $1,120.48 / $1,821.72 / $2,691.94	Professional		$1,120.48	$1,821.72	$2,691.94