Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $1,112.93 / $1,112.93 / $1,112.93	Facility		$1,112.93	$1,112.93	$1,112.93
Aetna Facility/Professional Professional Modifier Low / Median / High Price $689.27 / $1,112.93 / $1,847.88	Professional		$689.27	$1,112.93	$1,847.88
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $2,206.16 / $2,426.78 / $4,015.21	Facility		$2,206.16	$2,426.78	$4,015.21
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $1,985.54 / $2,051.73 / $2,713.57	Professional		$1,985.54	$2,051.73	$2,713.57
CareSource Facility/Professional Facility Modifier Low / Median / High Price $1,587.11 / $4,721.18 / $4,721.18	Facility		$1,587.11	$4,721.18	$4,721.18
Cigna Facility/Professional Facility Modifier Low / Median / High Price $1,427.14 / $4,560.95 / $9,209.12	Facility		$1,427.14	$4,560.95	$9,209.12
Cigna Facility/Professional Professional Modifier Low / Median / High Price $1,041.81 / $3,196.88 / $4,175.33	Professional		$1,041.81	$3,196.88	$4,175.33
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $532.91 / $1,669.40 / $2,537.08	Facility		$532.91	$1,669.40	$2,537.08
DeanCare Facility/Professional Professional Modifier Low / Median / High Price $1,263.20 / $2,206.16 / $2,647.39	Professional		$1,263.20	$2,206.16	$2,647.39
Medica Facility/Professional Facility Modifier Low / Median / High Price $922.49 / $2,200.28 / $8,775.70	Facility		$922.49	$2,200.28	$8,775.70
Medica Facility/Professional Professional Modifier Low / Median / High Price $993.77 / $1,243.74 / $2,402.23	Professional		$993.77	$1,243.74	$2,402.23
Molina Facility/Professional Professional Modifier Low / Median / High Price $50.00 / $70.00 / $1,300.13	Professional		$50.00	$70.00	$1,300.13
Prevea360 Facility/Professional Facility Modifier Low / Median / High Price $532.91 / $1,669.40 / $2,537.08	Facility		$532.91	$1,669.40	$2,537.08
Prevea360 Facility/Professional Professional Modifier Low / Median / High Price $1,263.20 / $2,206.16 / $2,647.39	Professional		$1,263.20	$2,206.16	$2,647.39
Quartz Facility/Professional Professional Modifier Low / Median / High Price $2,206.16 / $3,309.24 / $4,953.26	Professional		$2,206.16	$3,309.24	$4,953.26
Quartz Facility/Professional Facility Modifier Low / Median / High Price $1,427.14 / $4,308.89 / $8,775.70	Facility		$1,427.14	$4,308.89	$8,775.70
Quartz Facility/Professional Professional Modifier Low / Median / High Price $1,041.81 / $1,427.14 / $12,282.35	Professional		$1,041.81	$1,427.14	$12,282.35
Security Health Facility/Professional Professional Modifier Low / Median / High Price $2,206.16 / $2,206.16 / $2,206.16	Professional		$2,206.16	$2,206.16	$2,206.16
Security Health Facility/Professional Professional Modifier Low / Median / High Price $2,206.16 / $2,206.16 / $2,206.16	Professional		$2,206.16	$2,206.16	$2,206.16
United Facility/Professional Professional Modifier Low / Median / High Price $733.75 / $1,174.55 / $1,956.02	Professional		$733.75	$1,174.55	$1,956.02