Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $1,072.66 / $1,072.66 / $1,072.66	Facility		$1,072.66	$1,072.66	$1,072.66
Aetna Facility/Professional Professional Modifier Low / Median / High Price $664.33 / $1,072.66 / $1,781.01	Professional		$664.33	$1,072.66	$1,781.01
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $2,126.34 / $2,338.96 / $3,869.94	Facility		$2,126.34	$2,338.96	$3,869.94
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $1,913.70 / $1,977.50 / $2,615.39	Professional		$1,913.70	$1,977.50	$2,615.39
CareSource Facility/Professional Facility Modifier Low / Median / High Price $1,529.68 / $4,550.37 / $4,550.37	Facility		$1,529.68	$4,550.37	$4,550.37
Cigna Facility/Professional Facility Modifier Low / Median / High Price $1,020.64 / $4,395.85 / $8,876.03	Facility		$1,020.64	$4,395.85	$8,876.03
Cigna Facility/Professional Professional Modifier Low / Median / High Price $745.07 / $3,081.56 / $4,024.26	Professional		$745.07	$3,081.56	$4,024.26
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $513.63 / $1,608.99 / $2,445.29	Facility		$513.63	$1,608.99	$2,445.29
DeanCare Facility/Professional Professional Modifier Low / Median / High Price $1,217.49 / $2,126.34 / $2,551.61	Professional		$1,217.49	$2,126.34	$2,551.61
Medica Facility/Professional Facility Modifier Low / Median / High Price $889.11 / $2,118.69 / $8,461.77	Facility		$889.11	$2,118.69	$8,461.77
Medica Facility/Professional Professional Modifier Low / Median / High Price $953.62 / $1,198.73 / $2,315.32	Professional		$953.62	$1,198.73	$2,315.32
Molina Facility/Professional Professional Modifier Low / Median / High Price $50.00 / $70.00 / $1,120.89	Professional		$50.00	$70.00	$1,120.89
Prevea360 Facility/Professional Facility Modifier Low / Median / High Price $513.63 / $1,608.99 / $2,445.29	Facility		$513.63	$1,608.99	$2,445.29
Prevea360 Facility/Professional Professional Modifier Low / Median / High Price $1,217.49 / $2,126.34 / $2,551.61	Professional		$1,217.49	$2,126.34	$2,551.61
Quartz Facility/Professional Professional Modifier Low / Median / High Price $2,126.34 / $3,189.51 / $4,773.60	Professional		$2,126.34	$3,189.51	$4,773.60
Quartz Facility/Professional Facility Modifier Low / Median / High Price $1,020.64 / $4,153.00 / $8,461.77	Facility		$1,020.64	$4,153.00	$8,461.77
Quartz Facility/Professional Professional Modifier Low / Median / High Price $745.07 / $1,020.64 / $11,850.71	Professional		$745.07	$1,020.64	$11,850.71
Security Health Facility/Professional Professional Modifier Low / Median / High Price $2,126.34 / $2,126.34 / $2,126.34	Professional		$2,126.34	$2,126.34	$2,126.34
Security Health Facility/Professional Professional Modifier Low / Median / High Price $1,697.82 / $2,126.34 / $2,126.34	Professional		$1,697.82	$2,126.34	$2,126.34
United Facility/Professional Professional Modifier Low / Median / High Price $719.08 / $1,198.46 / $2,126.34	Professional		$719.08	$1,198.46	$2,126.34