Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $2,436.69 / $2,436.69 / $2,436.69	Facility		$2,436.69	$2,436.69	$2,436.69
Aetna Facility/Professional Professional Modifier Low / Median / High Price $2,023.07 / $2,436.69 / $4,082.38	Professional		$2,023.07	$2,436.69	$4,082.38
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $4,830.29 / $5,313.32 / $8,791.12	Facility		$4,830.29	$5,313.32	$8,791.12
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $4,177.71 / $4,492.17 / $5,941.25	Professional		$4,177.71	$4,492.17	$5,941.25
CareSource Facility/Professional Facility Modifier Low / Median / High Price $3,474.90 / $10,336.82 / $10,336.82	Facility		$3,474.90	$10,336.82	$10,336.82
Cigna Facility/Professional Facility Modifier Low / Median / High Price $2,886.72 / $10,664.52 / $20,162.12	Facility		$2,886.72	$10,664.52	$20,162.12
Cigna Facility/Professional Professional Modifier Low / Median / High Price $2,107.31 / $6,999.84 / $9,141.70	Professional		$2,107.31	$6,999.84	$9,141.70
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $1,389.75 / $3,655.05 / $5,554.83	Facility		$1,389.75	$3,655.05	$5,554.83
DeanCare Facility/Professional Professional Modifier Low / Median / High Price $2,765.71 / $4,714.47 / $5,796.35	Professional		$2,765.71	$4,714.47	$5,796.35
Medica Facility/Professional Facility Modifier Low / Median / High Price $2,405.71 / $4,830.29 / $22,493.11	Facility		$2,405.71	$4,830.29	$22,493.11
Medica Facility/Professional Professional Modifier Low / Median / High Price $2,205.62 / $3,227.47 / $5,259.59	Professional		$2,205.62	$3,227.47	$5,259.59
Molina Facility/Professional Professional Modifier Low / Median / High Price $50.00 / $70.00 / $3,259.74	Professional		$50.00	$70.00	$3,259.74
Prevea360 Facility/Professional Facility Modifier Low / Median / High Price $1,389.75 / $3,655.05 / $5,554.83	Facility		$1,389.75	$3,655.05	$5,554.83
Prevea360 Facility/Professional Professional Modifier Low / Median / High Price $2,765.71 / $4,714.47 / $5,796.35	Professional		$2,765.71	$4,714.47	$5,796.35
Quartz Facility/Professional Professional Modifier Low / Median / High Price $4,830.29 / $7,433.67 / $12,916.62	Professional		$4,830.29	$7,433.67	$12,916.62
Quartz Facility/Professional Facility Modifier Low / Median / High Price $2,886.72 / $9,434.16 / $22,493.11	Facility		$2,886.72	$9,434.16	$22,493.11
Quartz Facility/Professional Professional Modifier Low / Median / High Price $2,107.31 / $2,886.72 / $24,318.59	Professional		$2,107.31	$2,886.72	$24,318.59
Security Health Facility/Professional Professional Modifier Low / Median / High Price $4,830.29 / $4,830.29 / $4,830.29	Professional		$4,830.29	$4,830.29	$4,830.29
Security Health Facility/Professional Professional Modifier Low / Median / High Price $3,856.88 / $4,830.29 / $4,830.29	Professional		$3,856.88	$4,830.29	$4,830.29
United Facility/Professional Facility Modifier Low / Median / High Price $6,904.03 / $6,904.03 / $6,904.03	Facility		$6,904.03	$6,904.03	$6,904.03
United Facility/Professional Professional Modifier Low / Median / High Price $1,924.33 / $2,898.17 / $4,282.60	Professional		$1,924.33	$2,898.17	$4,282.60