Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $2,649.05 / $2,649.05 / $2,649.05	Facility		$2,649.05	$2,649.05	$2,649.05
Aetna Facility/Professional Professional Modifier Low / Median / High Price $2,499.40 / $2,649.05 / $5,043.59	Professional		$2,499.40	$2,649.05	$5,043.59
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $5,251.23 / $5,776.35 / $9,557.24	Facility		$5,251.23	$5,776.35	$9,557.24
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $4,883.64 / $4,883.64 / $6,459.01	Professional		$4,883.64	$4,883.64	$6,459.01
CareSource Facility/Professional Facility Modifier Low / Median / High Price $3,777.72 / $11,237.63 / $11,237.63	Facility		$3,777.72	$11,237.63	$11,237.63
Cigna Facility/Professional Facility Modifier Low / Median / High Price $3,323.97 / $11,100.32 / $21,918.57	Facility		$3,323.97	$11,100.32	$21,918.57
Cigna Facility/Professional Professional Modifier Low / Median / High Price $2,426.50 / $7,609.69 / $9,938.35	Professional		$2,426.50	$7,609.69	$9,938.35
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $2,649.05 / $4,327.35 / $6,038.91	Facility		$2,649.05	$4,327.35	$6,038.91
DeanCare Facility/Professional Professional Modifier Low / Median / High Price $5,251.23 / $5,562.49 / $6,301.48	Professional		$5,251.23	$5,562.49	$6,301.48
Medica Facility/Professional Facility Modifier Low / Median / High Price $3,295.85 / $5,251.23 / $25,033.69	Facility		$3,295.85	$5,251.23	$25,033.69
Medica Facility/Professional Professional Modifier Low / Median / High Price $2,502.98 / $3,493.04 / $5,740.15	Professional		$2,502.98	$3,493.04	$5,740.15
Molina Facility/Professional Professional Modifier Low / Median / High Price $50.00 / $70.00 / $6,519.48	Professional		$50.00	$70.00	$6,519.48
Prevea360 Facility/Professional Facility Modifier Low / Median / High Price $2,649.05 / $4,410.05 / $6,038.91	Facility		$2,649.05	$4,410.05	$6,038.91
Prevea360 Facility/Professional Professional Modifier Low / Median / High Price $5,251.23 / $5,562.49 / $6,301.48	Professional		$5,251.23	$5,562.49	$6,301.48
Quartz Facility/Professional Professional Modifier Low / Median / High Price $5,251.23 / $8,081.46 / $13,470.66	Professional		$5,251.23	$8,081.46	$13,470.66
Quartz Facility/Professional Facility Modifier Low / Median / High Price $3,323.97 / $10,256.29 / $25,033.69	Facility		$3,323.97	$10,256.29	$25,033.69
Quartz Facility/Professional Professional Modifier Low / Median / High Price $2,426.50 / $3,323.97 / $28,469.96	Professional		$2,426.50	$3,323.97	$28,469.96
Security Health Facility/Professional Professional Modifier Low / Median / High Price $5,251.23 / $5,251.23 / $5,251.23	Professional		$5,251.23	$5,251.23	$5,251.23
Security Health Facility/Professional Professional Modifier Low / Median / High Price $5,251.23 / $5,251.23 / $5,251.23	Professional		$5,251.23	$5,251.23	$5,251.23
United Facility/Professional Professional Modifier Low / Median / High Price $2,092.02 / $3,150.74 / $5,251.23	Professional		$2,092.02	$3,150.74	$5,251.23