Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $1,219.97 / $1,219.97 / $1,219.97	Facility		$1,219.97	$1,219.97	$1,219.97
Aetna Facility/Professional Professional Modifier Low / Median / High Price $778.20 / $1,219.97 / $2,025.61	Professional		$778.20	$1,219.97	$2,025.61
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $2,418.36 / $2,660.20 / $4,401.42	Facility		$2,418.36	$2,660.20	$4,401.42
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $2,176.52 / $2,249.07 / $2,974.58	Professional		$2,176.52	$2,249.07	$2,974.58
CareSource Facility/Professional Facility Modifier Low / Median / High Price $1,739.76 / $5,175.29 / $5,175.29	Facility		$1,739.76	$5,175.29	$5,175.29
Cigna Facility/Professional Facility Modifier Low / Median / High Price $1,167.30 / $5,000.00 / $10,095.06	Facility		$1,167.30	$5,000.00	$10,095.06
Cigna Facility/Professional Professional Modifier Low / Median / High Price $852.13 / $3,504.38 / $4,576.93	Professional		$852.13	$3,504.38	$4,576.93
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $601.66 / $1,829.96 / $2,781.11	Facility		$601.66	$1,829.96	$2,781.11
DeanCare Facility/Professional Professional Modifier Low / Median / High Price $1,384.70 / $1,868.10 / $2,902.03	Professional		$1,384.70	$1,868.10	$2,902.03
Medica Facility/Professional Facility Modifier Low / Median / High Price $1,041.51 / $2,418.36 / $9,793.70	Facility		$1,041.51	$2,418.36	$9,793.70
Medica Facility/Professional Professional Modifier Low / Median / High Price $963.44 / $1,404.20 / $2,633.29	Professional		$963.44	$1,404.20	$2,633.29
Molina Facility/Professional Professional Modifier Low / Median / High Price $50.00 / $70.00 / $1,527.98	Professional		$50.00	$70.00	$1,527.98
Prevea360 Facility/Professional Facility Modifier Low / Median / High Price $601.66 / $1,829.96 / $2,781.11	Facility		$601.66	$1,829.96	$2,781.11
Prevea360 Facility/Professional Professional Modifier Low / Median / High Price $1,384.70 / $1,868.10 / $2,902.03	Professional		$1,384.70	$1,868.10	$2,902.03
Quartz Facility/Professional Professional Modifier Low / Median / High Price $2,418.36 / $3,627.54 / $5,591.61	Professional		$2,418.36	$3,627.54	$5,591.61
Quartz Facility/Professional Facility Modifier Low / Median / High Price $1,167.30 / $4,723.35 / $9,793.70	Facility		$1,167.30	$4,723.35	$9,793.70
Quartz Facility/Professional Professional Modifier Low / Median / High Price $852.13 / $1,167.30 / $12,404.18	Professional		$852.13	$1,167.30	$12,404.18
Security Health Facility/Professional Professional Modifier Low / Median / High Price $2,418.36 / $2,418.36 / $2,418.36	Professional		$2,418.36	$2,418.36	$2,418.36
Security Health Facility/Professional Professional Modifier Low / Median / High Price $2,418.36 / $2,418.36 / $2,418.36	Professional		$2,418.36	$2,418.36	$2,418.36
United Facility/Professional Professional Modifier Low / Median / High Price $861.69 / $1,404.20 / $2,074.11	Professional		$861.69	$1,404.20	$2,074.11