Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $1,832.98 / $1,832.98 / $1,832.98	Facility		$1,832.98	$1,832.98	$1,832.98
Aetna Facility/Professional Professional Modifier Low / Median / High Price $1,189.44 / $1,832.98 / $3,043.44	Professional		$1,189.44	$1,832.98	$3,043.44
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $3,633.53 / $3,996.88 / $6,613.02	Facility		$3,633.53	$3,996.88	$6,613.02
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $3,142.63 / $3,379.18 / $4,469.24	Professional		$3,142.63	$3,379.18	$4,469.24
CareSource Facility/Professional Facility Modifier Low / Median / High Price $2,613.94 / $7,775.75 / $7,775.75	Facility		$2,613.94	$7,775.75	$7,775.75
Cigna Facility/Professional Facility Modifier Low / Median / High Price $1,784.15 / $7,512.15 / $15,167.08	Facility		$1,784.15	$7,512.15	$15,167.08
Cigna Facility/Professional Professional Modifier Low / Median / High Price $1,302.43 / $5,265.47 / $6,876.74	Professional		$1,302.43	$5,265.47	$6,876.74
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $919.62 / $2,749.47 / $4,178.56	Facility		$919.62	$2,749.47	$4,178.56
DeanCare Facility/Professional Professional Modifier Low / Median / High Price $2,080.46 / $3,633.53 / $4,360.24	Professional		$2,080.46	$3,633.53	$4,360.24
Medica Facility/Professional Facility Modifier Low / Median / High Price $1,591.89 / $3,633.53 / $15,230.69	Facility		$1,591.89	$3,633.53	$15,230.69
Medica Facility/Professional Professional Modifier Low / Median / High Price $1,636.73 / $2,146.23 / $3,956.47	Professional		$1,636.73	$2,146.23	$3,956.47
Molina Facility/Professional Professional Modifier Low / Median / High Price $50.00 / $70.00 / $1,244.26	Professional		$50.00	$70.00	$1,244.26
Prevea360 Facility/Professional Facility Modifier Low / Median / High Price $919.62 / $2,749.47 / $4,178.56	Facility		$919.62	$2,749.47	$4,178.56
Prevea360 Facility/Professional Professional Modifier Low / Median / High Price $2,080.46 / $3,633.53 / $4,360.24	Professional		$2,080.46	$3,633.53	$4,360.24
Quartz Facility/Professional Professional Modifier Low / Median / High Price $3,633.53 / $5,450.30 / $8,547.51	Professional		$3,633.53	$5,450.30	$8,547.51
Quartz Facility/Professional Facility Modifier Low / Median / High Price $1,784.15 / $7,096.74 / $15,230.69	Facility		$1,784.15	$7,096.74	$15,230.69
Quartz Facility/Professional Professional Modifier Low / Median / High Price $1,302.43 / $1,784.15 / $17,819.31	Professional		$1,302.43	$1,784.15	$17,819.31
Security Health Facility/Professional Professional Modifier Low / Median / High Price $3,633.53 / $3,633.53 / $3,633.53	Professional		$3,633.53	$3,633.53	$3,633.53
Security Health Facility/Professional Professional Modifier Low / Median / High Price $3,633.53 / $3,633.53 / $3,633.53	Professional		$3,633.53	$3,633.53	$3,633.53
United Facility/Professional Professional Modifier Low / Median / High Price $1,208.49 / $2,143.62 / $3,221.55	Professional		$1,208.49	$2,143.62	$3,221.55