Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $1,066.66 / $1,066.66 / $1,066.66	Facility		$1,066.66	$1,066.66	$1,066.66
Aetna Facility/Professional Professional Modifier Low / Median / High Price $851.43 / $1,066.66 / $1,771.06	Professional		$851.43	$1,066.66	$1,771.06
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $2,114.46 / $2,325.91 / $3,848.32	Facility		$2,114.46	$2,325.91	$3,848.32
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $1,828.79 / $1,966.45 / $2,600.78	Professional		$1,828.79	$1,966.45	$2,600.78
CareSource Facility/Professional Facility Modifier Low / Median / High Price $1,521.13 / $4,524.93 / $4,524.93	Facility		$1,521.13	$4,524.93	$4,524.93
Cigna Facility/Professional Facility Modifier Low / Median / High Price $1,367.82 / $4,371.46 / $8,825.65	Facility		$1,367.82	$4,371.46	$8,825.65
Cigna Facility/Professional Professional Modifier Low / Median / High Price $998.51 / $3,064.22 / $4,001.78	Professional		$998.51	$3,064.22	$4,001.78
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $658.29 / $1,599.99 / $2,431.63	Facility		$658.29	$1,599.99	$2,431.63
DeanCare Facility/Professional Professional Modifier Low / Median / High Price $1,210.69 / $2,043.89 / $2,537.35	Professional		$1,210.69	$2,043.89	$2,537.35
Medica Facility/Professional Facility Modifier Low / Median / High Price $1,066.66 / $2,114.46 / $10,228.89	Facility		$1,066.66	$2,114.46	$10,228.89
Medica Facility/Professional Professional Modifier Low / Median / High Price $983.12 / $1,412.82 / $2,302.38	Professional		$983.12	$1,412.82	$2,302.38
Molina Facility/Professional Professional Modifier Low / Median / High Price $50.00 / $70.00 / $1,397.87	Professional		$50.00	$70.00	$1,397.87
Prevea360 Facility/Professional Facility Modifier Low / Median / High Price $658.29 / $1,599.99 / $2,431.63	Facility		$658.29	$1,599.99	$2,431.63
Prevea360 Facility/Professional Professional Modifier Low / Median / High Price $1,210.69 / $2,043.89 / $2,537.35	Professional		$1,210.69	$2,043.89	$2,537.35
Quartz Facility/Professional Professional Modifier Low / Median / High Price $2,114.46 / $3,254.08 / $6,118.56	Professional		$2,114.46	$3,254.08	$6,118.56
Quartz Facility/Professional Facility Modifier Low / Median / High Price $1,367.82 / $4,129.80 / $10,228.89	Facility		$1,367.82	$4,129.80	$10,228.89
Quartz Facility/Professional Professional Modifier Low / Median / High Price $998.51 / $1,367.82 / $12,164.54	Professional		$998.51	$1,367.82	$12,164.54
Security Health Facility/Professional Professional Modifier Low / Median / High Price $2,114.46 / $2,114.46 / $2,114.46	Professional		$2,114.46	$2,114.46	$2,114.46
Security Health Facility/Professional Professional Modifier Low / Median / High Price $2,114.46 / $2,114.46 / $2,114.46	Professional		$2,114.46	$2,114.46	$2,114.46
United Facility/Professional Facility Modifier Low / Median / High Price $1.63 / $1,534.46 / $1,536.34	Facility		$1.63	$1,534.46	$1,536.34
United Facility/Professional Professional Modifier Low / Median / High Price $842.37 / $1,212.90 / $1,813.47	Professional		$842.37	$1,212.90	$1,813.47