Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $1,794.54 / $1,794.54 / $1,794.54	Facility		$1,794.54	$1,794.54	$1,794.54
Aetna Facility/Professional Professional Modifier Low / Median / High Price $1,411.94 / $1,794.54 / $2,979.62	Professional		$1,411.94	$1,794.54	$2,979.62
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $3,557.34 / $3,913.07 / $6,474.36	Facility		$3,557.34	$3,913.07	$6,474.36
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $3,076.74 / $3,308.33 / $4,375.52	Professional		$3,076.74	$3,308.33	$4,375.52
CareSource Facility/Professional Facility Modifier Low / Median / High Price $2,559.14 / $7,612.71 / $7,612.71	Facility		$2,559.14	$7,612.71	$7,612.71
Cigna Facility/Professional Facility Modifier Low / Median / High Price $2,117.90 / $7,354.58 / $14,847.97	Facility		$2,117.90	$7,354.58	$14,847.97
Cigna Facility/Professional Professional Modifier Low / Median / High Price $1,546.07 / $5,924.63 / $6,732.54	Professional		$1,546.07	$5,924.63	$6,732.54
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $1,091.64 / $2,691.81 / $4,090.94	Facility		$1,091.64	$2,691.81	$4,090.94
DeanCare Facility/Professional Professional Modifier Low / Median / High Price $2,036.84 / $3,557.34 / $4,390.54	Professional		$2,036.84	$3,557.34	$4,390.54
Medica Facility/Professional Facility Modifier Low / Median / High Price $1,794.54 / $3,557.34 / $17,754.05	Facility		$1,794.54	$3,557.34	$17,754.05
Medica Facility/Professional Professional Modifier Low / Median / High Price $1,654.00 / $2,376.90 / $4,016.16	Professional		$1,654.00	$2,376.90	$4,016.16
Molina Facility/Professional Professional Modifier Low / Median / High Price $50.00 / $70.00 / $2,400.67	Professional		$50.00	$70.00	$2,400.67
Prevea360 Facility/Professional Facility Modifier Low / Median / High Price $1,091.64 / $2,745.65 / $4,090.94	Facility		$1,091.64	$2,745.65	$4,090.94
Prevea360 Facility/Professional Professional Modifier Low / Median / High Price $2,036.84 / $3,557.34 / $4,390.54	Professional		$2,036.84	$3,557.34	$4,390.54
Quartz Facility/Professional Professional Modifier Low / Median / High Price $3,557.34 / $5,474.61 / $10,146.40	Professional		$3,557.34	$5,474.61	$10,146.40
Quartz Facility/Professional Facility Modifier Low / Median / High Price $2,117.90 / $6,947.92 / $17,754.05	Facility		$2,117.90	$6,947.92	$17,754.05
Quartz Facility/Professional Professional Modifier Low / Median / High Price $1,546.07 / $2,117.90 / $21,074.59	Professional		$1,546.07	$2,117.90	$21,074.59
Security Health Facility/Professional Professional Modifier Low / Median / High Price $3,557.34 / $3,557.34 / $3,557.34	Professional		$3,557.34	$3,557.34	$3,557.34
Security Health Facility/Professional Professional Modifier Low / Median / High Price $2,840.44 / $3,557.34 / $3,557.34	Professional		$2,840.44	$3,557.34	$3,557.34
United Facility/Professional Professional Modifier Low / Median / High Price $1,417.20 / $2,234.46 / $3,050.97	Professional		$1,417.20	$2,234.46	$3,050.97