Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $1,992.07 / $1,992.07 / $1,992.07	Facility		$1,992.07	$1,992.07	$1,992.07
Aetna Facility/Professional Professional Modifier Low / Median / High Price $1,364.01 / $1,992.07 / $3,307.59	Professional		$1,364.01	$1,992.07	$3,307.59
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $3,948.90 / $4,343.79 / $7,187.00	Facility		$3,948.90	$4,343.79	$7,187.00
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $3,554.01 / $3,672.48 / $4,857.14	Professional		$3,554.01	$3,672.48	$4,857.14
CareSource Facility/Professional Facility Modifier Low / Median / High Price $2,840.83 / $8,450.65 / $8,450.65	Facility		$2,840.83	$8,450.65	$8,450.65
Cigna Facility/Professional Facility Modifier Low / Median / High Price $2,694.60 / $8,164.11 / $16,482.66	Facility		$2,694.60	$8,164.11	$16,482.66
Cigna Facility/Professional Professional Modifier Low / Median / High Price $1,967.06 / $6,576.78 / $7,473.61	Professional		$1,967.06	$6,576.78	$7,473.61
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $1,054.58 / $2,988.11 / $4,541.24	Facility		$1,054.58	$2,988.11	$4,541.24
DeanCare Facility/Professional Professional Modifier Low / Median / High Price $2,261.05 / $3,948.90 / $4,738.68	Professional		$2,261.05	$3,948.90	$4,738.68
Medica Facility/Professional Facility Modifier Low / Median / High Price $1,825.53 / $3,948.90 / $17,419.57	Facility		$1,825.53	$3,948.90	$17,419.57
Medica Facility/Professional Professional Modifier Low / Median / High Price $1,778.80 / $2,460.69 / $4,299.87	Professional		$1,778.80	$2,460.69	$4,299.87
Molina Facility/Professional Professional Modifier Low / Median / High Price $50.00 / $70.00 / $1,492.05	Professional		$50.00	$70.00	$1,492.05
Prevea360 Facility/Professional Facility Modifier Low / Median / High Price $1,054.58 / $2,988.11 / $4,541.24	Facility		$1,054.58	$2,988.11	$4,541.24
Prevea360 Facility/Professional Professional Modifier Low / Median / High Price $2,261.05 / $3,948.90 / $4,738.68	Professional		$2,261.05	$3,948.90	$4,738.68
Quartz Facility/Professional Professional Modifier Low / Median / High Price $3,948.90 / $6,077.24 / $9,801.12	Professional		$3,948.90	$6,077.24	$9,801.12
Quartz Facility/Professional Facility Modifier Low / Median / High Price $2,694.60 / $7,712.70 / $17,419.57	Facility		$2,694.60	$7,712.70	$17,419.57
Quartz Facility/Professional Professional Modifier Low / Median / High Price $1,967.06 / $2,694.60 / $21,045.47	Professional		$1,967.06	$2,694.60	$21,045.47
Security Health Facility/Professional Professional Modifier Low / Median / High Price $3,948.90 / $3,948.90 / $3,948.90	Professional		$3,948.90	$3,948.90	$3,948.90
Security Health Facility/Professional Professional Modifier Low / Median / High Price $3,948.90 / $3,948.90 / $3,948.90	Professional		$3,948.90	$3,948.90	$3,948.90
United Facility/Professional Professional Modifier Low / Median / High Price $1,361.29 / $2,178.06 / $3,501.16	Professional		$1,361.29	$2,178.06	$3,501.16