Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $1,933.83 / $1,933.83 / $1,933.83	Facility		$1,933.83	$1,933.83	$1,933.83
Aetna Facility/Professional Professional Modifier Low / Median / High Price $1,294.33 / $1,933.83 / $3,210.88	Professional		$1,294.33	$1,933.83	$3,210.88
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $3,833.45 / $4,216.80 / $6,976.88	Facility		$3,833.45	$4,216.80	$6,976.88
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $3,315.55 / $3,565.11 / $4,715.14	Professional		$3,315.55	$3,565.11	$4,715.14
CareSource Facility/Professional Facility Modifier Low / Median / High Price $2,757.78 / $8,203.58 / $8,203.58	Facility		$2,757.78	$8,203.58	$8,203.58
Cigna Facility/Professional Facility Modifier Low / Median / High Price $2,479.82 / $7,924.91 / $16,001.22	Facility		$2,479.82	$7,924.91	$16,001.22
Cigna Facility/Professional Professional Modifier Low / Median / High Price $1,810.27 / $5,555.16 / $7,255.10	Professional		$1,810.27	$5,555.16	$7,255.10
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $1,000.71 / $2,900.75 / $4,408.47	Facility		$1,000.71	$2,900.75	$4,408.47
DeanCare Facility/Professional Professional Modifier Low / Median / High Price $2,194.94 / $3,833.45 / $4,600.14	Professional		$2,194.94	$3,833.45	$4,600.14
Medica Facility/Professional Facility Modifier Low / Median / High Price $1,732.27 / $3,833.45 / $16,444.91	Facility		$1,732.27	$3,833.45	$16,444.91
Medica Facility/Professional Professional Modifier Low / Median / High Price $1,726.79 / $2,334.98 / $4,174.14	Professional		$1,726.79	$2,334.98	$4,174.14
Molina Facility/Professional Professional Modifier Low / Median / High Price $50.00 / $70.00 / $1,228.44	Professional		$50.00	$70.00	$1,228.44
Prevea360 Facility/Professional Facility Modifier Low / Median / High Price $1,000.71 / $2,900.75 / $4,408.47	Facility		$1,000.71	$2,900.75	$4,408.47
Prevea360 Facility/Professional Professional Modifier Low / Median / High Price $2,194.94 / $3,833.45 / $4,600.14	Professional		$2,194.94	$3,833.45	$4,600.14
Quartz Facility/Professional Professional Modifier Low / Median / High Price $3,833.45 / $5,899.57 / $9,301.29	Professional		$3,833.45	$5,899.57	$9,301.29
Quartz Facility/Professional Facility Modifier Low / Median / High Price $2,479.82 / $7,487.20 / $16,444.91	Facility		$2,479.82	$7,487.20	$16,444.91
Quartz Facility/Professional Professional Modifier Low / Median / High Price $1,810.27 / $2,479.82 / $22,490.28	Professional		$1,810.27	$2,479.82	$22,490.28
Security Health Facility/Professional Professional Modifier Low / Median / High Price $3,833.45 / $3,833.45 / $3,833.45	Professional		$3,833.45	$3,833.45	$3,833.45
Security Health Facility/Professional Professional Modifier Low / Median / High Price $3,833.45 / $3,833.45 / $3,833.45	Professional		$3,833.45	$3,833.45	$3,833.45
United Facility/Professional Professional Modifier Low / Median / High Price $1,349.45 / $2,300.07 / $3,833.45	Professional		$1,349.45	$2,300.07	$3,833.45