Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $2,213.02 / $2,213.02 / $2,213.02	Facility		$2,213.02	$2,213.02	$2,213.02
Aetna Facility/Professional Professional Modifier Low / Median / High Price $1,837.38 / $2,213.02 / $3,707.67	Professional		$1,837.38	$2,213.02	$3,707.67
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $4,386.88 / $4,825.57 / $7,984.12	Facility		$4,386.88	$4,825.57	$7,984.12
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $4,079.80 / $4,079.80 / $5,395.86	Professional		$4,079.80	$4,079.80	$5,395.86
CareSource Facility/Professional Facility Modifier Low / Median / High Price $3,155.91 / $9,387.92 / $9,387.92	Facility		$3,155.91	$9,387.92	$9,387.92
Cigna Facility/Professional Facility Modifier Low / Median / High Price $2,448.80 / $9,069.36 / $18,310.50	Facility		$2,448.80	$9,069.36	$18,310.50
Cigna Facility/Professional Professional Modifier Low / Median / High Price $1,787.62 / $6,357.19 / $8,302.51	Professional		$1,787.62	$6,357.19	$8,302.51
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $1,262.19 / $3,319.53 / $5,044.91	Facility		$1,262.19	$3,319.53	$5,044.91
DeanCare Facility/Professional Professional Modifier Low / Median / High Price $2,511.82 / $4,281.77 / $5,264.26	Professional		$2,511.82	$4,281.77	$5,264.26
Medica Facility/Professional Facility Modifier Low / Median / High Price $2,184.90 / $4,386.88 / $20,504.11	Facility		$2,184.90	$4,386.88	$20,504.11
Medica Facility/Professional Professional Modifier Low / Median / High Price $1,981.38 / $2,931.19 / $4,776.77	Professional		$1,981.38	$2,931.19	$4,776.77
Molina Facility/Professional Professional Modifier Low / Median / High Price $50.00 / $70.00 / $2,856.56	Professional		$50.00	$70.00	$2,856.56
Prevea360 Facility/Professional Facility Modifier Low / Median / High Price $1,262.19 / $3,319.53 / $5,044.91	Facility		$1,262.19	$3,319.53	$5,044.91
Prevea360 Facility/Professional Professional Modifier Low / Median / High Price $2,511.82 / $4,281.77 / $5,264.26	Professional		$2,511.82	$4,281.77	$5,264.26
Quartz Facility/Professional Professional Modifier Low / Median / High Price $4,386.88 / $6,751.24 / $11,731.25	Professional		$4,386.88	$6,751.24	$11,731.25
Quartz Facility/Professional Facility Modifier Low / Median / High Price $2,448.80 / $8,568.12 / $20,504.11	Facility		$2,448.80	$8,568.12	$20,504.11
Quartz Facility/Professional Professional Modifier Low / Median / High Price $1,787.62 / $2,448.80 / $22,086.40	Professional		$1,787.62	$2,448.80	$22,086.40
Security Health Facility/Professional Professional Modifier Low / Median / High Price $4,386.88 / $4,386.88 / $4,386.88	Professional		$4,386.88	$4,386.88	$4,386.88
Security Health Facility/Professional Professional Modifier Low / Median / High Price $3,502.82 / $4,386.88 / $4,386.88	Professional		$3,502.82	$4,386.88	$4,386.88
United Facility/Professional Professional Modifier Low / Median / High Price $1,747.67 / $2,583.58 / $3,762.43	Professional		$1,747.67	$2,583.58	$3,762.43