Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $2,920.74 / $2,920.74 / $2,920.74	Facility		$2,920.74	$2,920.74	$2,920.74
Aetna Facility/Professional Professional Modifier Low / Median / High Price $2,176.55 / $2,920.74 / $4,849.53	Professional		$2,176.55	$2,920.74	$4,849.53
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $5,789.81 / $6,368.79 / $10,537.45	Facility		$5,789.81	$6,368.79	$10,537.45
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $5,210.82 / $5,384.52 / $7,121.46	Professional		$5,210.82	$5,384.52	$7,121.46
CareSource Facility/Professional Facility Modifier Low / Median / High Price $4,165.18 / $12,390.19 / $12,390.19	Facility		$4,165.18	$12,390.19	$12,390.19
Cigna Facility/Professional Facility Modifier Low / Median / High Price $3,745.37 / $11,969.91 / $24,167.67	Facility		$3,745.37	$11,969.91	$24,167.67
Cigna Facility/Professional Professional Modifier Low / Median / High Price $2,734.12 / $9,642.74 / $10,957.66	Professional		$2,734.12	$9,642.74	$10,957.66
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $1,679.50 / $4,381.10 / $6,658.28	Facility		$1,679.50	$4,381.10	$6,658.28
DeanCare Facility/Professional Professional Modifier Low / Median / High Price $3,315.11 / $5,789.81 / $6,952.84	Professional		$3,315.11	$5,789.81	$6,952.84
Medica Facility/Professional Facility Modifier Low / Median / High Price $2,907.28 / $5,789.81 / $27,462.75	Facility		$2,907.28	$5,789.81	$27,462.75
Medica Facility/Professional Professional Modifier Low / Median / High Price $2,636.46 / $3,868.60 / $6,503.81	Professional		$2,636.46	$3,868.60	$6,503.81
Molina Facility/Professional Professional Modifier Low / Median / High Price $50.00 / $70.00 / $3,907.29	Professional		$50.00	$70.00	$3,907.29
Prevea360 Facility/Professional Facility Modifier Low / Median / High Price $1,679.50 / $4,381.10 / $6,658.28	Facility		$1,679.50	$4,381.10	$6,658.28
Prevea360 Facility/Professional Professional Modifier Low / Median / High Price $3,315.11 / $5,789.81 / $6,952.84	Professional		$3,315.11	$5,789.81	$6,952.84
Quartz Facility/Professional Professional Modifier Low / Median / High Price $5,789.81 / $8,910.33 / $15,609.54	Professional		$5,789.81	$8,910.33	$15,609.54
Quartz Facility/Professional Facility Modifier Low / Median / High Price $3,745.37 / $11,308.22 / $27,462.75	Facility		$3,745.37	$11,308.22	$27,462.75
Quartz Facility/Professional Professional Modifier Low / Median / High Price $2,734.12 / $3,745.37 / $34,404.35	Professional		$2,734.12	$3,745.37	$34,404.35
Security Health Facility/Professional Professional Modifier Low / Median / High Price $5,789.81 / $5,789.81 / $5,789.81	Professional		$5,789.81	$5,789.81	$5,789.81
Security Health Facility/Professional Professional Modifier Low / Median / High Price $5,789.81 / $5,789.81 / $5,789.81	Professional		$5,789.81	$5,789.81	$5,789.81
United Facility/Professional Professional Modifier Low / Median / High Price $2,167.94 / $3,468.70 / $5,133.34	Professional		$2,167.94	$3,468.70	$5,133.34