Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $2,313.40 / $2,313.40 / $2,313.40	Facility		$2,313.40	$2,313.40	$2,313.40
Aetna Facility/Professional Professional Modifier Low / Median / High Price $1,853.81 / $2,313.40 / $3,841.11	Professional		$1,853.81	$2,313.40	$3,841.11
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $4,585.87 / $5,044.46 / $8,346.28	Facility		$4,585.87	$5,044.46	$8,346.28
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $4,127.28 / $4,264.85 / $5,640.62	Professional		$4,127.28	$4,264.85	$5,640.62
CareSource Facility/Professional Facility Modifier Low / Median / High Price $3,299.06 / $9,813.76 / $9,813.76	Facility		$3,299.06	$9,813.76	$9,813.76
Cigna Facility/Professional Facility Modifier Low / Median / High Price $2,780.72 / $9,481.19 / $19,141.84	Facility		$2,780.72	$9,481.19	$19,141.84
Cigna Facility/Professional Professional Modifier Low / Median / High Price $2,029.93 / $6,645.47 / $8,679.12	Professional		$2,029.93	$6,645.47	$8,679.12
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $1,433.28 / $3,470.10 / $5,273.75	Facility		$1,433.28	$3,470.10	$5,273.75
DeanCare Facility/Professional Professional Modifier Low / Median / High Price $2,625.76 / $4,585.87 / $5,503.04	Professional		$2,625.76	$4,585.87	$5,503.04
Medica Facility/Professional Facility Modifier Low / Median / High Price $2,313.40 / $4,585.87 / $23,421.34	Facility		$2,313.40	$4,585.87	$23,421.34
Medica Facility/Professional Professional Modifier Low / Median / High Price $2,132.21 / $3,064.15 / $5,177.37	Professional		$2,132.21	$3,064.15	$5,177.37
Molina Facility/Professional Professional Modifier Low / Median / High Price $50.00 / $70.00 / $3,094.79	Professional		$50.00	$70.00	$3,094.79
Prevea360 Facility/Professional Facility Modifier Low / Median / High Price $1,433.28 / $3,518.45 / $5,273.75	Facility		$1,433.28	$3,518.45	$5,273.75
Prevea360 Facility/Professional Professional Modifier Low / Median / High Price $2,625.76 / $4,585.87 / $5,503.04	Professional		$2,625.76	$4,585.87	$5,503.04
Quartz Facility/Professional Professional Modifier Low / Median / High Price $4,585.87 / $7,057.51 / $13,321.11	Professional		$4,585.87	$7,057.51	$13,321.11
Quartz Facility/Professional Facility Modifier Low / Median / High Price $2,780.72 / $8,956.78 / $23,421.34	Facility		$2,780.72	$8,956.78	$23,421.34
Quartz Facility/Professional Professional Modifier Low / Median / High Price $2,029.93 / $2,780.72 / $29,548.98	Professional		$2,029.93	$2,780.72	$29,548.98
Security Health Facility/Professional Professional Modifier Low / Median / High Price $4,585.87 / $4,585.87 / $4,585.87	Professional		$4,585.87	$4,585.87	$4,585.87
Security Health Facility/Professional Professional Modifier Low / Median / High Price $3,661.71 / $4,585.87 / $4,585.87	Professional		$3,661.71	$4,585.87	$4,585.87
United Facility/Professional Professional Modifier Low / Median / High Price $1,826.95 / $2,933.77 / $4,585.87	Professional		$1,826.95	$2,933.77	$4,585.87