Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $1,252.55 / $1,252.55 / $1,252.55	Facility		$1,252.55	$1,252.55	$1,252.55
Aetna Facility/Professional Professional Modifier Low / Median / High Price $869.76 / $1,252.55 / $2,079.69	Professional		$869.76	$1,252.55	$2,079.69
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $2,482.94 / $2,731.23 / $4,518.95	Facility		$2,482.94	$2,731.23	$4,518.95
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $2,309.13 / $2,309.13 / $3,054.01	Professional		$2,309.13	$2,309.13	$3,054.01
CareSource Facility/Professional Facility Modifier Low / Median / High Price $1,786.23 / $5,313.49 / $5,313.49	Facility		$1,786.23	$5,313.49	$5,313.49
Cigna Facility/Professional Facility Modifier Low / Median / High Price $1,606.19 / $5,133.18 / $10,363.77	Facility		$1,606.19	$5,133.18	$10,363.77
Cigna Facility/Professional Professional Modifier Low / Median / High Price $1,172.52 / $3,598.13 / $4,699.16	Professional		$1,172.52	$3,598.13	$4,699.16
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $672.46 / $1,878.83 / $2,855.38	Facility		$672.46	$1,878.83	$2,855.38
DeanCare Facility/Professional Professional Modifier Low / Median / High Price $1,421.68 / $2,367.17 / $2,979.53	Professional		$1,421.68	$2,367.17	$2,979.53
Medica Facility/Professional Facility Modifier Low / Median / High Price $1,164.06 / $2,482.94 / $11,048.78	Facility		$1,164.06	$2,482.94	$11,048.78
Medica Facility/Professional Professional Modifier Low / Median / High Price $1,118.45 / $1,569.07 / $2,703.62	Professional		$1,118.45	$1,569.07	$2,703.62
Molina Facility/Professional Professional Modifier Low / Median / High Price $50.00 / $70.00 / $1,675.63	Professional		$50.00	$70.00	$1,675.63
Prevea360 Facility/Professional Facility Modifier Low / Median / High Price $672.46 / $1,878.83 / $2,855.38	Facility		$672.46	$1,878.83	$2,855.38
Prevea360 Facility/Professional Professional Modifier Low / Median / High Price $1,421.68 / $2,367.17 / $2,979.53	Professional		$1,421.68	$2,367.17	$2,979.53
Quartz Facility/Professional Professional Modifier Low / Median / High Price $2,482.94 / $3,821.20 / $6,250.04	Professional		$2,482.94	$3,821.20	$6,250.04
Quartz Facility/Professional Facility Modifier Low / Median / High Price $1,606.19 / $4,849.50 / $11,048.78	Facility		$1,606.19	$4,849.50	$11,048.78
Quartz Facility/Professional Professional Modifier Low / Median / High Price $1,172.52 / $1,606.19 / $13,780.11	Professional		$1,172.52	$1,606.19	$13,780.11
Security Health Facility/Professional Professional Modifier Low / Median / High Price $2,482.94 / $2,482.94 / $2,482.94	Professional		$2,482.94	$2,482.94	$2,482.94
Security Health Facility/Professional Professional Modifier Low / Median / High Price $2,482.94 / $2,482.94 / $2,482.94	Professional		$2,482.94	$2,482.94	$2,482.94
United Facility/Professional Professional Modifier Low / Median / High Price $868.03 / $1,321.91 / $2,129.52	Professional		$868.03	$1,321.91	$2,129.52