Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $2,374.91 / $2,374.91 / $2,374.91	Facility		$2,374.91	$2,374.91	$2,374.91
Aetna Facility/Professional Professional Modifier Low / Median / High Price $1,754.23 / $2,374.91 / $3,943.24	Professional		$1,754.23	$2,374.91	$3,943.24
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $4,707.80 / $5,178.58 / $8,568.20	Facility		$4,707.80	$5,178.58	$8,568.20
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $4,237.02 / $4,378.25 / $5,790.59	Professional		$4,237.02	$4,378.25	$5,790.59
CareSource Facility/Professional Facility Modifier Low / Median / High Price $3,386.78 / $10,074.69 / $10,074.69	Facility		$3,386.78	$10,074.69	$10,074.69
Cigna Facility/Professional Facility Modifier Low / Median / High Price $3,364.97 / $9,732.59 / $19,651.28	Facility		$3,364.97	$9,732.59	$19,651.28
Cigna Facility/Professional Professional Modifier Low / Median / High Price $2,456.42 / $6,822.19 / $8,909.87	Professional		$2,456.42	$6,822.19	$8,909.87
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $1,310.23 / $3,562.37 / $5,413.97	Facility		$1,310.23	$3,562.37	$5,413.97
DeanCare Facility/Professional Professional Modifier Low / Median / High Price $2,695.58 / $4,707.80 / $5,649.36	Professional		$2,695.58	$4,707.80	$5,649.36
Medica Facility/Professional Facility Modifier Low / Median / High Price $2,268.06 / $4,707.80 / $21,225.02	Facility		$2,268.06	$4,707.80	$21,225.02
Medica Facility/Professional Professional Modifier Low / Median / High Price $2,120.65 / $3,057.20 / $5,126.22	Professional		$2,120.65	$3,057.20	$5,126.22
Molina Facility/Professional Professional Modifier Low / Median / High Price $50.00 / $70.00 / $1,976.79	Professional		$50.00	$70.00	$1,976.79
Prevea360 Facility/Professional Facility Modifier Low / Median / High Price $1,310.23 / $3,562.37 / $5,413.97	Facility		$1,310.23	$3,562.37	$5,413.97
Prevea360 Facility/Professional Professional Modifier Low / Median / High Price $2,695.58 / $4,707.80 / $5,649.36	Professional		$2,695.58	$4,707.80	$5,649.36
Quartz Facility/Professional Professional Modifier Low / Median / High Price $4,707.80 / $7,245.15 / $12,177.89	Professional		$4,707.80	$7,245.15	$12,177.89
Quartz Facility/Professional Facility Modifier Low / Median / High Price $3,364.97 / $9,194.92 / $21,225.02	Facility		$3,364.97	$9,194.92	$21,225.02
Quartz Facility/Professional Professional Modifier Low / Median / High Price $2,456.42 / $3,364.97 / $23,979.78	Professional		$2,456.42	$3,364.97	$23,979.78
Security Health Facility/Professional Professional Modifier Low / Median / High Price $4,707.80 / $4,707.80 / $4,707.80	Professional		$4,707.80	$4,707.80	$4,707.80
Security Health Facility/Professional Professional Modifier Low / Median / High Price $4,707.80 / $4,707.80 / $4,707.80	Professional		$4,707.80	$4,707.80	$4,707.80
United Facility/Professional Professional Modifier Low / Median / High Price $1,691.28 / $2,824.68 / $4,037.67	Professional		$1,691.28	$2,824.68	$4,037.67