Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $1,027.66 / $1,027.66 / $1,027.66	Facility		$1,027.66	$1,027.66	$1,027.66
Aetna Facility/Professional Professional Modifier Low / Median / High Price $853.21 / $1,027.66 / $1,721.71	Professional		$853.21	$1,027.66	$1,721.71
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $2,037.14 / $2,240.85 / $3,707.59	Facility		$2,037.14	$2,240.85	$3,707.59
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $1,833.42 / $1,894.54 / $2,505.67	Professional		$1,833.42	$1,894.54	$2,505.67
CareSource Facility/Professional Facility Modifier Low / Median / High Price $1,465.51 / $4,359.47 / $4,359.47	Facility		$1,465.51	$4,359.47	$4,359.47
Cigna Facility/Professional Facility Modifier Low / Median / High Price $1,317.79 / $4,211.97 / $8,503.75	Facility		$1,317.79	$4,211.97	$8,503.75
Cigna Facility/Professional Professional Modifier Low / Median / High Price $961.99 / $2,952.19 / $3,855.44	Professional		$961.99	$2,952.19	$3,855.44
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $586.11 / $1,541.49 / $2,342.71	Facility		$586.11	$1,541.49	$2,342.71
DeanCare Facility/Professional Professional Modifier Low / Median / High Price $1,166.41 / $1,988.29 / $2,444.57	Professional		$1,166.41	$1,988.29	$2,444.57
Medica Facility/Professional Facility Modifier Low / Median / High Price $1,014.58 / $2,037.14 / $9,502.08	Facility		$1,014.58	$2,037.14	$9,502.08
Medica Facility/Professional Professional Modifier Low / Median / High Price $920.08 / $1,361.15 / $2,229.84	Professional		$920.08	$1,361.15	$2,229.84
Molina Facility/Professional Professional Modifier Low / Median / High Price $50.00 / $70.00 / $1,374.76	Professional		$50.00	$70.00	$1,374.76
Prevea360 Facility/Professional Facility Modifier Low / Median / High Price $586.11 / $1,541.49 / $2,342.71	Facility		$586.11	$1,541.49	$2,342.71
Prevea360 Facility/Professional Professional Modifier Low / Median / High Price $1,166.41 / $1,988.29 / $2,444.57	Professional		$1,166.41	$1,988.29	$2,444.57
Quartz Facility/Professional Professional Modifier Low / Median / High Price $2,037.14 / $3,135.07 / $5,447.08	Professional		$2,037.14	$3,135.07	$5,447.08
Quartz Facility/Professional Facility Modifier Low / Median / High Price $1,317.79 / $3,978.78 / $9,502.08	Facility		$1,317.79	$3,978.78	$9,502.08
Quartz Facility/Professional Professional Modifier Low / Median / High Price $961.99 / $1,317.79 / $14,479.07	Professional		$961.99	$1,317.79	$14,479.07
Security Health Facility/Professional Professional Modifier Low / Median / High Price $2,037.14 / $2,037.14 / $2,037.14	Professional		$2,037.14	$2,037.14	$2,037.14
Security Health Facility/Professional Professional Modifier Low / Median / High Price $2,037.14 / $2,037.14 / $2,037.14	Professional		$2,037.14	$2,037.14	$2,037.14
United Facility/Professional Professional Modifier Low / Median / High Price $756.58 / $1,222.28 / $2,037.14	Professional		$756.58	$1,222.28	$2,037.14