Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $8,836.06 / $8,836.06 / $8,836.06	Facility		$8,836.06	$8,836.06	$8,836.06
Aetna Facility/Professional Professional Modifier Low / Median / High Price $7,336.16 / $8,836.06 / $14,803.79	Professional		$7,336.16	$8,836.06	$14,803.79
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $17,515.82 / $19,267.40 / $31,878.79	Facility		$17,515.82	$19,267.40	$31,878.79
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $15,764.23 / $16,289.71 / $21,544.45	Professional		$15,764.23	$16,289.71	$21,544.45
CareSource Facility/Professional Facility Modifier Low / Median / High Price $12,600.84 / $37,483.85 / $37,483.85	Facility		$12,600.84	$37,483.85	$37,483.85
Cigna Facility/Professional Facility Modifier Low / Median / High Price $9,812.54 / $38,673.80 / $73,111.82	Facility		$9,812.54	$38,673.80	$73,111.82
Cigna Facility/Professional Professional Modifier Low / Median / High Price $8,340.66 / $25,382.81 / $33,150.05	Professional		$8,340.66	$25,382.81	$33,150.05
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $8,836.06 / $13,943.85 / $20,143.18	Facility		$8,836.06	$13,943.85	$20,143.18
DeanCare Facility/Professional Professional Modifier Low / Median / High Price $17,095.98 / $17,515.82 / $21,018.98	Professional		$17,095.98	$17,515.82	$21,018.98
Medica Facility/Professional Facility Modifier Low / Median / High Price $11,501.68 / $17,515.82 / $81,836.25	Facility		$11,501.68	$17,515.82	$81,836.25
Medica Facility/Professional Professional Modifier Low / Median / High Price $8,144.05 / $11,803.99 / $19,585.91	Professional		$8,144.05	$11,803.99	$19,585.91
Molina Facility/Professional Professional Modifier Low / Median / High Price $50.00 / $65.00 / $85.00	Professional		$50.00	$65.00	$85.00
Prevea360 Facility/Professional Facility Modifier Low / Median / High Price $8,836.06 / $14,012.66 / $20,143.18	Facility		$8,836.06	$14,012.66	$20,143.18
Prevea360 Facility/Professional Professional Modifier Low / Median / High Price $17,095.98 / $17,515.82 / $21,018.98	Professional		$17,095.98	$17,515.82	$21,018.98
Quartz Facility/Professional Professional Modifier Low / Median / High Price $17,515.82 / $26,956.25 / $47,007.29	Professional		$17,515.82	$26,956.25	$47,007.29
Quartz Facility/Professional Facility Modifier Low / Median / High Price $9,812.54 / $34,210.58 / $81,836.25	Facility		$9,812.54	$34,210.58	$81,836.25
Quartz Facility/Professional Professional Modifier Low / Median / High Price $8,340.66 / $9,812.54 / $89,678.01	Professional		$8,340.66	$9,812.54	$89,678.01
Security Health Facility/Professional Professional Modifier Low / Median / High Price $17,515.82 / $17,515.82 / $17,515.82	Professional		$17,515.82	$17,515.82	$17,515.82
Security Health Facility/Professional Professional Modifier Low / Median / High Price $17,515.82 / $17,515.82 / $17,515.82	Professional		$17,515.82	$17,515.82	$17,515.82
United Facility/Professional Professional Modifier Low / Median / High Price $6,528.64 / $10,445.82 / $15,529.80	Professional		$6,528.64	$10,445.82	$15,529.80