Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $2,317.41 / $2,317.41 / $2,317.41	Facility		$2,317.41	$2,317.41	$2,317.41
Aetna Facility/Professional Professional Modifier Low / Median / High Price $1,720.40 / $2,317.41 / $3,847.77	Professional		$1,720.40	$2,317.41	$3,847.77
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $4,593.82 / $5,053.20 / $8,360.75	Facility		$4,593.82	$5,053.20	$8,360.75
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $3,973.19 / $4,272.25 / $5,650.39	Professional		$3,973.19	$4,272.25	$5,650.39
CareSource Facility/Professional Facility Modifier Low / Median / High Price $3,304.79 / $9,830.77 / $9,830.77	Facility		$3,304.79	$9,830.77	$9,830.77
Cigna Facility/Professional Facility Modifier Low / Median / High Price $2,550.04 / $9,497.14 / $19,175.43	Facility		$2,550.04	$9,497.14	$19,175.43
Cigna Facility/Professional Professional Modifier Low / Median / High Price $1,861.53 / $6,657.19 / $8,694.16	Professional		$1,861.53	$6,657.19	$8,694.16
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $1,314.38 / $3,476.12 / $5,282.89	Facility		$1,314.38	$3,476.12	$5,282.89
DeanCare Facility/Professional Professional Modifier Low / Median / High Price $2,630.32 / $4,593.82 / $5,512.58	Professional		$2,630.32	$4,593.82	$5,512.58
Medica Facility/Professional Facility Modifier Low / Median / High Price $2,275.23 / $4,593.82 / $21,140.73	Facility		$2,275.23	$4,593.82	$21,140.73
Medica Facility/Professional Professional Modifier Low / Median / High Price $2,069.31 / $3,063.81 / $5,089.89	Professional		$2,069.31	$3,063.81	$5,089.89
Molina Facility/Professional Professional Modifier Low / Median / High Price $50.00 / $70.00 / $3,100.16	Professional		$50.00	$70.00	$3,100.16
Prevea360 Facility/Professional Facility Modifier Low / Median / High Price $1,314.38 / $3,476.12 / $5,282.89	Facility		$1,314.38	$3,476.12	$5,282.89
Prevea360 Facility/Professional Professional Modifier Low / Median / High Price $2,630.32 / $4,593.82 / $5,512.58	Professional		$2,630.32	$4,593.82	$5,512.58
Quartz Facility/Professional Professional Modifier Low / Median / High Price $4,593.82 / $7,069.73 / $12,216.03	Professional		$4,593.82	$7,069.73	$12,216.03
Quartz Facility/Professional Facility Modifier Low / Median / High Price $2,550.04 / $8,972.29 / $21,140.73	Facility		$2,550.04	$8,972.29	$21,140.73
Quartz Facility/Professional Professional Modifier Low / Median / High Price $1,861.53 / $2,550.04 / $26,362.41	Professional		$1,861.53	$2,550.04	$26,362.41
Security Health Facility/Professional Professional Modifier Low / Median / High Price $4,593.82 / $4,593.82 / $4,593.82	Professional		$4,593.82	$4,593.82	$4,593.82
Security Health Facility/Professional Professional Modifier Low / Median / High Price $3,668.07 / $4,593.82 / $4,593.82	Professional		$3,668.07	$4,593.82	$4,593.82
United Facility/Professional Facility Modifier Low / Median / High Price $6,529.56 / $6,529.56 / $6,529.56	Facility		$6,529.56	$6,529.56	$6,529.56
United Facility/Professional Professional Modifier Low / Median / High Price $1,696.63 / $3,055.74 / $4,593.82	Professional		$1,696.63	$3,055.74	$4,593.82