Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $2,049.82 / $2,049.82 / $2,049.82	Facility		$2,049.82	$2,049.82	$2,049.82
Aetna Facility/Professional Professional Modifier Low / Median / High Price $1,701.85 / $2,049.82 / $3,434.20	Professional		$1,701.85	$2,049.82	$3,434.20
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $4,063.39 / $4,469.72 / $7,395.37	Facility		$4,063.39	$4,469.72	$7,395.37
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $3,778.95 / $3,778.95 / $4,997.96	Professional		$3,778.95	$3,778.95	$4,997.96
CareSource Facility/Professional Facility Modifier Low / Median / High Price $2,923.19 / $8,695.65 / $8,695.65	Facility		$2,923.19	$8,695.65	$8,695.65
Cigna Facility/Professional Facility Modifier Low / Median / High Price $2,282.71 / $8,400.54 / $16,961.32	Facility		$2,282.71	$8,400.54	$16,961.32
Cigna Facility/Professional Professional Modifier Low / Median / High Price $1,666.39 / $6,767.44 / $7,690.28	Professional		$1,666.39	$6,767.44	$7,690.28
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $1,176.59 / $3,074.73 / $4,672.89	Facility		$1,176.59	$3,074.73	$4,672.89
DeanCare Facility/Professional Professional Modifier Low / Median / High Price $2,326.60 / $3,965.99 / $4,876.07	Professional		$2,326.60	$3,965.99	$4,876.07
Medica Facility/Professional Facility Modifier Low / Median / High Price $2,036.74 / $4,063.39 / $19,065.24	Facility		$2,036.74	$4,063.39	$19,065.24
Medica Facility/Professional Professional Modifier Low / Median / High Price $1,847.02 / $2,715.04 / $4,443.21	Professional		$1,847.02	$2,715.04	$4,443.21
Molina Facility/Professional Professional Modifier Low / Median / High Price $50.00 / $70.00 / $2,625.06	Professional		$50.00	$70.00	$2,625.06
Prevea360 Facility/Professional Facility Modifier Low / Median / High Price $1,176.59 / $3,074.73 / $4,672.89	Facility		$1,176.59	$3,074.73	$4,672.89
Prevea360 Facility/Professional Professional Modifier Low / Median / High Price $2,326.60 / $3,965.99 / $4,876.07	Professional		$2,326.60	$3,965.99	$4,876.07
Quartz Facility/Professional Professional Modifier Low / Median / High Price $4,063.39 / $6,253.41 / $10,935.31	Professional		$4,063.39	$6,253.41	$10,935.31
Quartz Facility/Professional Facility Modifier Low / Median / High Price $2,282.71 / $7,936.30 / $19,065.24	Facility		$2,282.71	$7,936.30	$19,065.24
Quartz Facility/Professional Professional Modifier Low / Median / High Price $1,666.39 / $2,282.71 / $20,393.65	Professional		$1,666.39	$2,282.71	$20,393.65
Security Health Facility/Professional Professional Modifier Low / Median / High Price $4,063.39 / $4,063.39 / $4,063.39	Professional		$4,063.39	$4,063.39	$4,063.39
Security Health Facility/Professional Professional Modifier Low / Median / High Price $3,244.51 / $4,063.39 / $4,063.39	Professional		$3,244.51	$4,063.39	$4,063.39
United Facility/Professional Facility Modifier Low / Median / High Price $1,982.23 / $1,982.23 / $1,982.23	Facility		$1,982.23	$1,982.23	$1,982.23
United Facility/Professional Professional Modifier Low / Median / High Price $1,518.78 / $2,430.05 / $3,602.66	Professional		$1,518.78	$2,430.05	$3,602.66