Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $2,568.83 / $2,568.83 / $2,568.83	Facility		$2,568.83	$2,568.83	$2,568.83
Aetna Facility/Professional Professional Modifier Low / Median / High Price $2,132.77 / $2,568.83 / $4,303.76	Professional		$2,132.77	$2,568.83	$4,303.76
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $5,092.22 / $5,601.44 / $9,267.84	Facility		$5,092.22	$5,601.44	$9,267.84
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $4,582.99 / $4,735.76 / $6,263.43	Professional		$4,582.99	$4,735.76	$6,263.43
CareSource Facility/Professional Facility Modifier Low / Median / High Price $3,663.33 / $10,897.35 / $10,897.35	Facility		$3,663.33	$10,897.35	$10,897.35
Cigna Facility/Professional Facility Modifier Low / Median / High Price $3,294.10 / $11,243.58 / $21,255.18	Facility		$3,294.10	$11,243.58	$21,255.18
Cigna Facility/Professional Professional Modifier Low / Median / High Price $2,404.69 / $7,379.06 / $9,637.43	Professional		$2,404.69	$7,379.06	$9,637.43
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $1,465.11 / $3,853.25 / $5,856.05	Facility		$1,465.11	$3,853.25	$5,856.05
DeanCare Facility/Professional Professional Modifier Low / Median / High Price $2,915.68 / $4,970.12 / $6,110.66	Professional		$2,915.68	$4,970.12	$6,110.66
Medica Facility/Professional Facility Modifier Low / Median / High Price $2,536.17 / $5,092.22 / $23,712.81	Facility		$2,536.17	$5,092.22	$23,712.81
Medica Facility/Professional Professional Modifier Low / Median / High Price $2,325.23 / $3,402.47 / $5,544.80	Professional		$2,325.23	$3,402.47	$5,544.80
Molina Facility/Professional Professional Modifier Low / Median / High Price $50.00 / $65.00 / $85.00	Professional		$50.00	$65.00	$85.00
Prevea360 Facility/Professional Facility Modifier Low / Median / High Price $1,465.11 / $3,853.25 / $5,856.05	Facility		$1,465.11	$3,853.25	$5,856.05
Prevea360 Facility/Professional Professional Modifier Low / Median / High Price $2,915.68 / $4,970.12 / $6,110.66	Professional		$2,915.68	$4,970.12	$6,110.66
Quartz Facility/Professional Professional Modifier Low / Median / High Price $5,092.22 / $7,836.72 / $13,617.20	Professional		$5,092.22	$7,836.72	$13,617.20
Quartz Facility/Professional Facility Modifier Low / Median / High Price $3,294.10 / $9,945.74 / $23,712.81	Facility		$3,294.10	$9,945.74	$23,712.81
Quartz Facility/Professional Professional Modifier Low / Median / High Price $2,404.69 / $3,294.10 / $25,637.24	Professional		$2,404.69	$3,294.10	$25,637.24
Security Health Facility/Professional Professional Modifier Low / Median / High Price $5,092.22 / $5,092.22 / $5,092.22	Professional		$5,092.22	$5,092.22	$5,092.22
Security Health Facility/Professional Professional Modifier Low / Median / High Price $5,092.22 / $5,092.22 / $5,092.22	Professional		$5,092.22	$5,092.22	$5,092.22
United Facility/Professional Professional Modifier Low / Median / High Price $2,028.67 / $3,236.84 / $4,514.84	Professional		$2,028.67	$3,236.84	$4,514.84