Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $10,751.73 / $10,751.73 / $10,751.73	Facility		$10,751.73	$10,751.73	$10,751.73
Aetna Facility/Professional Professional Modifier Low / Median / High Price $8,698.98 / $10,751.73 / $17,851.93	Professional		$8,698.98	$10,751.73	$17,851.93
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $21,313.25 / $23,444.58 / $38,790.12	Facility		$21,313.25	$23,444.58	$38,790.12
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $19,099.55 / $19,821.32 / $26,215.29	Professional		$19,099.55	$19,821.32	$26,215.29
CareSource Facility/Professional Facility Modifier Low / Median / High Price $15,332.71 / $45,610.36 / $45,610.36	Facility		$15,332.71	$45,610.36	$45,610.36
Cigna Facility/Professional Facility Modifier Low / Median / High Price $12,752.32 / $47,058.14 / $88,963.29	Facility		$12,752.32	$47,058.14	$88,963.29
Cigna Facility/Professional Professional Modifier Low / Median / High Price $9,309.19 / $30,885.47 / $40,336.99	Professional		$9,309.19	$30,885.47	$40,336.99
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $6,364.39 / $17,050.59 / $24,510.24	Facility		$6,364.39	$17,050.59	$24,510.24
DeanCare Facility/Professional Professional Modifier Low / Median / High Price $20,713.39 / $21,313.25 / $25,575.90	Professional		$20,713.39	$21,313.25	$25,575.90
Medica Facility/Professional Facility Modifier Low / Median / High Price $10,751.73 / $21,313.25 / $98,186.49	Facility		$10,751.73	$21,313.25	$98,186.49
Medica Facility/Professional Professional Modifier Low / Median / High Price $9,740.92 / $14,143.08 / $23,229.70	Professional		$9,740.92	$14,143.08	$23,229.70
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 $6,364.39 / $17,050.59 / $24,510.24	Facility		$6,364.39	$17,050.59	$24,510.24
Prevea360 Facility/Professional Professional Modifier Low / Median / High Price $20,713.39 / $21,313.25 / $25,575.90	Professional		$20,713.39	$21,313.25	$25,575.90
Quartz Facility/Professional Professional Modifier Low / Median / High Price $21,313.25 / $32,800.39 / $56,335.67	Professional		$21,313.25	$32,800.39	$56,335.67
Quartz Facility/Professional Facility Modifier Low / Median / High Price $12,752.32 / $41,627.44 / $98,186.49	Facility		$12,752.32	$41,627.44	$98,186.49
Quartz Facility/Professional Professional Modifier Low / Median / High Price $9,309.19 / $12,752.32 / $106,003.63	Professional		$9,309.19	$12,752.32	$106,003.63
Security Health Facility/Professional Professional Modifier Low / Median / High Price $21,313.25 / $21,313.25 / $21,313.25	Professional		$21,313.25	$21,313.25	$21,313.25
Security Health Facility/Professional Professional Modifier Low / Median / High Price $21,313.25 / $21,313.25 / $21,313.25	Professional		$21,313.25	$21,313.25	$21,313.25
United Facility/Professional Professional Modifier Low / Median / High Price $7,824.10 / $12,518.55 / $18,896.66	Professional		$7,824.10	$12,518.55	$18,896.66