Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $2,077.98 / $2,077.98 / $2,077.98	Facility		$2,077.98	$2,077.98	$2,077.98
Aetna Facility/Professional Professional Modifier Low / Median / High Price $1,497.63 / $2,077.98 / $3,450.25	Professional		$1,497.63	$2,077.98	$3,450.25
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $4,119.22 / $4,531.14 / $7,496.98	Facility		$4,119.22	$4,531.14	$7,496.98
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $3,707.29 / $3,830.87 / $5,066.64	Professional		$3,707.29	$3,830.87	$5,066.64
CareSource Facility/Professional Facility Modifier Low / Median / High Price $2,963.36 / $8,815.12 / $8,815.12	Facility		$2,963.36	$8,815.12	$8,815.12
Cigna Facility/Professional Facility Modifier Low / Median / High Price $2,160.07 / $8,515.90 / $17,193.64	Facility		$2,160.07	$8,515.90	$17,193.64
Cigna Facility/Professional Professional Modifier Low / Median / High Price $1,576.85 / $5,969.06 / $7,795.95	Professional		$1,576.85	$5,969.06	$7,795.95
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $1,113.38 / $3,116.99 / $4,737.10	Facility		$1,113.38	$3,116.99	$4,737.10
DeanCare Facility/Professional Professional Modifier Low / Median / High Price $2,358.58 / $3,931.57 / $4,943.06	Professional		$2,358.58	$3,931.57	$4,943.06
Medica Facility/Professional Facility Modifier Low / Median / High Price $1,927.30 / $4,119.22 / $18,029.93	Facility		$1,927.30	$4,119.22	$18,029.93
Medica Facility/Professional Professional Modifier Low / Median / High Price $1,855.52 / $2,597.88 / $4,485.33	Professional		$1,855.52	$2,597.88	$4,485.33
Molina Facility/Professional Professional Modifier Low / Median / High Price $50.00 / $70.00 / $2,403.05	Professional		$50.00	$70.00	$2,403.05
Prevea360 Facility/Professional Facility Modifier Low / Median / High Price $1,113.38 / $3,116.99 / $4,737.10	Facility		$1,113.38	$3,116.99	$4,737.10
Prevea360 Facility/Professional Professional Modifier Low / Median / High Price $2,358.58 / $3,931.57 / $4,943.06	Professional		$2,358.58	$3,931.57	$4,943.06
Quartz Facility/Professional Professional Modifier Low / Median / High Price $4,119.22 / $6,339.33 / $10,348.15	Professional		$4,119.22	$6,339.33	$10,348.15
Quartz Facility/Professional Facility Modifier Low / Median / High Price $2,160.07 / $8,045.36 / $18,029.93	Facility		$2,160.07	$8,045.36	$18,029.93
Quartz Facility/Professional Professional Modifier Low / Median / High Price $1,576.85 / $2,160.07 / $19,461.27	Professional		$1,576.85	$2,160.07	$19,461.27
Security Health Facility/Professional Professional Modifier Low / Median / High Price $4,119.22 / $4,119.22 / $4,119.22	Professional		$4,119.22	$4,119.22	$4,119.22
Security Health Facility/Professional Professional Modifier Low / Median / High Price $3,289.12 / $4,119.22 / $4,119.22	Professional		$3,289.12	$4,119.22	$4,119.22
United Facility/Professional Professional Modifier Low / Median / High Price $1,370.02 / $2,299.48 / $3,532.88	Professional		$1,370.02	$2,299.48	$3,532.88