Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $1,008.31 / $1,008.31 / $1,008.31	Facility		$1,008.31	$1,008.31	$1,008.31
Aetna Facility/Professional Professional Modifier Low / Median / High Price $766.76 / $1,008.31 / $1,674.17	Professional		$766.76	$1,008.31	$1,674.17
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $1,998.78 / $2,198.66 / $3,637.78	Facility		$1,998.78	$2,198.66	$3,637.78
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $1,798.90 / $1,858.87 / $2,458.48	Professional		$1,798.90	$1,858.87	$2,458.48
CareSource Facility/Professional Facility Modifier Low / Median / High Price $1,437.92 / $4,277.39 / $4,277.39	Facility		$1,437.92	$4,277.39	$4,277.39
Cigna Facility/Professional Facility Modifier Low / Median / High Price $1,408.48 / $4,132.25 / $8,342.79	Facility		$1,408.48	$4,132.25	$8,342.79
Cigna Facility/Professional Professional Modifier Low / Median / High Price $1,028.19 / $2,896.41 / $3,782.84	Professional		$1,028.19	$2,896.41	$3,782.84
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $592.83 / $1,512.47 / $2,298.60	Facility		$592.83	$1,512.47	$2,298.60
DeanCare Facility/Professional Professional Modifier Low / Median / High Price $1,144.46 / $1,998.78 / $2,454.19	Professional		$1,144.46	$1,998.78	$2,454.19
Medica Facility/Professional Facility Modifier Low / Median / High Price $1,008.31 / $1,998.78 / $9,898.48	Facility		$1,008.31	$1,998.78	$9,898.48
Medica Facility/Professional Professional Modifier Low / Median / High Price $918.28 / $1,335.53 / $2,256.60	Professional		$918.28	$1,335.53	$2,256.60
Molina Facility/Professional Professional Modifier Low / Median / High Price $50.00 / $70.00 / $1,348.89	Professional		$50.00	$70.00	$1,348.89
Prevea360 Facility/Professional Facility Modifier Low / Median / High Price $592.83 / $1,512.47 / $2,298.60	Facility		$592.83	$1,512.47	$2,298.60
Prevea360 Facility/Professional Professional Modifier Low / Median / High Price $1,144.46 / $1,998.78 / $2,454.19	Professional		$1,144.46	$1,998.78	$2,454.19
Quartz Facility/Professional Professional Modifier Low / Median / High Price $1,998.78 / $3,076.05 / $5,510.31	Professional		$1,998.78	$3,076.05	$5,510.31
Quartz Facility/Professional Facility Modifier Low / Median / High Price $1,408.48 / $3,903.86 / $9,898.48	Facility		$1,408.48	$3,903.86	$9,898.48
Quartz Facility/Professional Professional Modifier Low / Median / High Price $1,028.19 / $1,408.48 / $14,199.48	Professional		$1,028.19	$1,408.48	$14,199.48
Security Health Facility/Professional Professional Modifier Low / Median / High Price $1,998.78 / $1,998.78 / $1,998.78	Professional		$1,998.78	$1,998.78	$1,998.78
Security Health Facility/Professional Professional Modifier Low / Median / High Price $1,998.78 / $1,998.78 / $1,998.78	Professional		$1,998.78	$1,998.78	$1,998.78
United Facility/Professional Professional Modifier Low / Median / High Price $765.23 / $1,224.36 / $2,176.42	Professional		$765.23	$1,224.36	$2,176.42