Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $2,906.89 / $2,906.89 / $2,906.89	Facility		$2,906.89	$2,906.89	$2,906.89
Aetna Facility/Professional Professional Modifier Low / Median / High Price $2,298.42 / $2,906.89 / $4,826.54	Professional		$2,298.42	$2,906.89	$4,826.54
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $5,762.36 / $6,338.60 / $10,487.50	Facility		$5,762.36	$6,338.60	$10,487.50
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $5,046.42 / $5,358.99 / $7,087.70	Professional		$5,046.42	$5,358.99	$7,087.70
CareSource Facility/Professional Facility Modifier Low / Median / High Price $4,145.43 / $12,331.45 / $12,331.45	Facility		$4,145.43	$12,331.45	$12,331.45
Cigna Facility/Professional Facility Modifier Low / Median / High Price $3,728.42 / $12,180.30 / $24,052.91	Facility		$3,728.42	$12,180.30	$24,052.91
Cigna Facility/Professional Professional Modifier Low / Median / High Price $2,721.75 / $8,350.31 / $10,905.71	Professional		$2,721.75	$8,350.31	$10,905.71
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $2,906.89 / $4,609.89 / $6,626.71	Facility		$2,906.89	$4,609.89	$6,626.71
DeanCare Facility/Professional Professional Modifier Low / Median / High Price $5,762.36 / $6,157.35 / $6,914.83	Professional		$5,762.36	$6,157.35	$6,914.83
Medica Facility/Professional Facility Modifier Low / Median / High Price $3,762.02 / $5,762.36 / $26,807.65	Facility		$3,762.02	$5,762.36	$26,807.65
Medica Facility/Professional Professional Modifier Low / Median / High Price $2,679.23 / $3,856.19 / $6,406.26	Professional		$2,679.23	$3,856.19	$6,406.26
Molina Facility/Professional Professional Modifier Low / Median / High Price $50.00 / $65.00 / $6,131.93	Professional		$50.00	$65.00	$6,131.93
Prevea360 Facility/Professional Facility Modifier Low / Median / High Price $2,906.89 / $4,686.76 / $6,626.71	Facility		$2,906.89	$4,686.76	$6,626.71
Prevea360 Facility/Professional Professional Modifier Low / Median / High Price $5,762.36 / $6,157.35 / $6,914.83	Professional		$5,762.36	$6,157.35	$6,914.83
Quartz Facility/Professional Professional Modifier Low / Median / High Price $5,762.36 / $8,868.09 / $15,375.68	Professional		$5,762.36	$8,868.09	$15,375.68
Quartz Facility/Professional Facility Modifier Low / Median / High Price $3,728.42 / $11,254.60 / $26,807.65	Facility		$3,728.42	$11,254.60	$26,807.65
Quartz Facility/Professional Professional Modifier Low / Median / High Price $2,721.75 / $3,728.42 / $30,647.77	Professional		$2,721.75	$3,728.42	$30,647.77
Security Health Facility/Professional Professional Modifier Low / Median / High Price $5,762.36 / $5,762.36 / $5,762.36	Professional		$5,762.36	$5,762.36	$5,762.36
Security Health Facility/Professional Professional Modifier Low / Median / High Price $5,762.36 / $5,762.36 / $5,762.36	Professional		$5,762.36	$5,762.36	$5,762.36
United Facility/Professional Professional Modifier Low / Median / High Price $2,006.41 / $3,416.67 / $5,109.00	Professional		$2,006.41	$3,416.67	$5,109.00