Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $2,261.73 / $2,261.73 / $2,261.73	Facility		$2,261.73	$2,261.73	$2,261.73
Aetna Facility/Professional Professional Modifier Low / Median / High Price $1,877.80 / $2,261.73 / $3,789.25	Professional		$1,877.80	$2,261.73	$3,789.25
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $4,483.45 / $4,931.80 / $8,159.88	Facility		$4,483.45	$4,931.80	$8,159.88
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $4,035.10 / $4,169.60 / $5,514.64	Professional		$4,035.10	$4,169.60	$5,514.64
CareSource Facility/Professional Facility Modifier Low / Median / High Price $3,225.38 / $9,594.58 / $9,594.58	Facility		$3,225.38	$9,594.58	$9,594.58
Cigna Facility/Professional Facility Modifier Low / Median / High Price $2,502.67 / $9,269.19 / $18,714.97	Facility		$2,502.67	$9,269.19	$18,714.97
Cigna Facility/Professional Professional Modifier Low / Median / High Price $1,826.95 / $6,496.88 / $8,485.28	Professional		$1,826.95	$6,496.88	$8,485.28
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $1,289.96 / $3,392.60 / $5,155.97	Facility		$1,289.96	$3,392.60	$5,155.97
DeanCare Facility/Professional Professional Modifier Low / Median / High Price $2,567.12 / $4,375.97 / $5,380.14	Professional		$2,567.12	$4,375.97	$5,380.14
Medica Facility/Professional Facility Modifier Low / Median / High Price $2,232.98 / $4,483.45 / $20,912.72	Facility		$2,232.98	$4,483.45	$20,912.72
Medica Facility/Professional Professional Modifier Low / Median / High Price $2,024.98 / $2,995.72 / $4,907.56	Professional		$2,024.98	$2,995.72	$4,907.56
Molina Facility/Professional Professional Modifier Low / Median / High Price $50.00 / $70.00 / $2,919.18	Professional		$50.00	$70.00	$2,919.18
Prevea360 Facility/Professional Facility Modifier Low / Median / High Price $1,289.96 / $3,392.60 / $5,155.97	Facility		$1,289.96	$3,392.60	$5,155.97
Prevea360 Facility/Professional Professional Modifier Low / Median / High Price $2,567.12 / $4,375.97 / $5,380.14	Professional		$2,567.12	$4,375.97	$5,380.14
Quartz Facility/Professional Professional Modifier Low / Median / High Price $4,483.45 / $6,899.88 / $11,989.20	Professional		$4,483.45	$6,899.88	$11,989.20
Quartz Facility/Professional Facility Modifier Low / Median / High Price $2,502.67 / $8,756.74 / $20,912.72	Facility		$2,502.67	$8,756.74	$20,912.72
Quartz Facility/Professional Professional Modifier Low / Median / High Price $1,826.95 / $2,502.67 / $22,572.40	Professional		$1,826.95	$2,502.67	$22,572.40
Security Health Facility/Professional Professional Modifier Low / Median / High Price $4,483.45 / $4,483.45 / $4,483.45	Professional		$4,483.45	$4,483.45	$4,483.45
Security Health Facility/Professional Professional Modifier Low / Median / High Price $3,579.94 / $4,483.45 / $4,483.45	Professional		$3,579.94	$4,483.45	$4,483.45
United Facility/Professional Professional Modifier Low / Median / High Price $1,564.52 / $2,664.18 / $3,975.10	Professional		$1,564.52	$2,664.18	$3,975.10