Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $1,930.94 / $1,930.94 / $1,930.94	Facility		$1,930.94	$1,930.94	$1,930.94
Aetna Facility/Professional Professional Modifier Low / Median / High Price $1,323.76 / $1,930.94 / $3,206.09	Professional		$1,323.76	$1,930.94	$3,206.09
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $3,827.72 / $4,210.49 / $6,966.45	Facility		$3,827.72	$4,210.49	$6,966.45
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $3,444.94 / $3,559.78 / $4,708.09	Professional		$3,444.94	$3,559.78	$4,708.09
CareSource Facility/Professional Facility Modifier Low / Median / High Price $2,753.64 / $8,191.32 / $8,191.32	Facility		$2,753.64	$8,191.32	$8,191.32
Cigna Facility/Professional Facility Modifier Low / Median / High Price $2,476.09 / $7,913.65 / $15,977.42	Facility		$2,476.09	$7,913.65	$15,977.42
Cigna Facility/Professional Professional Modifier Low / Median / High Price $1,807.55 / $5,546.72 / $7,244.26	Professional		$1,807.55	$5,546.72	$7,244.26
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $1,023.47 / $2,896.41 / $4,401.88	Facility		$1,023.47	$2,896.41	$4,401.88
DeanCare Facility/Professional Professional Modifier Low / Median / High Price $2,191.65 / $3,827.72 / $4,593.26	Professional		$2,191.65	$3,827.72	$4,593.26
Medica Facility/Professional Facility Modifier Low / Median / High Price $1,771.66 / $3,827.72 / $16,803.40	Facility		$1,771.66	$3,827.72	$16,803.40
Medica Facility/Professional Professional Modifier Low / Median / High Price $1,668.98 / $2,388.09 / $4,167.91	Professional		$1,668.98	$2,388.09	$4,167.91
Molina Facility/Professional Professional Modifier Low / Median / High Price $50.00 / $70.00 / $1,730.70	Professional		$50.00	$70.00	$1,730.70
Prevea360 Facility/Professional Facility Modifier Low / Median / High Price $1,023.47 / $2,896.41 / $4,401.88	Facility		$1,023.47	$2,896.41	$4,401.88
Prevea360 Facility/Professional Professional Modifier Low / Median / High Price $2,191.65 / $3,827.72 / $4,593.26	Professional		$2,191.65	$3,827.72	$4,593.26
Quartz Facility/Professional Professional Modifier Low / Median / High Price $3,827.72 / $5,890.70 / $9,512.06	Professional		$3,827.72	$5,890.70	$9,512.06
Quartz Facility/Professional Facility Modifier Low / Median / High Price $2,476.09 / $7,476.02 / $16,803.40	Facility		$2,476.09	$7,476.02	$16,803.40
Quartz Facility/Professional Professional Modifier Low / Median / High Price $1,807.55 / $2,476.09 / $19,260.05	Professional		$1,807.55	$2,476.09	$19,260.05
Security Health Facility/Professional Professional Modifier Low / Median / High Price $3,827.72 / $3,827.72 / $3,827.72	Professional		$3,827.72	$3,827.72	$3,827.72
Security Health Facility/Professional Professional Modifier Low / Median / High Price $3,827.72 / $3,827.72 / $3,827.72	Professional		$3,827.72	$3,827.72	$3,827.72
United Facility/Professional Professional Modifier Low / Median / High Price $1,321.12 / $2,136.96 / $3,393.72	Professional		$1,321.12	$2,136.96	$3,393.72