Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $2,748.02 / $2,748.02 / $2,748.02	Facility		$2,748.02	$2,748.02	$2,748.02
Aetna Facility/Professional Professional Modifier Low / Median / High Price $1,820.74 / $2,748.02 / $4,562.76	Professional		$1,820.74	$2,748.02	$4,562.76
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $5,447.43 / $5,992.17 / $9,914.32	Facility		$5,447.43	$5,992.17	$9,914.32
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $4,711.47 / $5,066.10 / $6,700.33	Professional		$4,711.47	$5,066.10	$6,700.33
CareSource Facility/Professional Facility Modifier Low / Median / High Price $3,918.87 / $11,657.50 / $11,657.50	Facility		$3,918.87	$11,657.50	$11,657.50
Cigna Facility/Professional Facility Modifier Low / Median / High Price $3,523.90 / $11,261.67 / $22,738.72	Facility		$3,523.90	$11,261.67	$22,738.72
Cigna Facility/Professional Professional Modifier Low / Median / High Price $2,572.44 / $7,894.22 / $10,309.70	Professional		$2,572.44	$7,894.22	$10,309.70
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $1,407.71 / $4,122.03 / $6,264.54	Facility		$1,407.71	$4,122.03	$6,264.54
DeanCare Facility/Professional Professional Modifier Low / Median / High Price $3,119.08 / $5,329.38 / $6,536.92	Professional		$3,119.08	$5,329.38	$6,536.92
Medica Facility/Professional Facility Modifier Low / Median / High Price $2,436.80 / $5,447.43 / $23,227.17	Facility		$2,436.80	$5,447.43	$23,227.17
Medica Facility/Professional Professional Modifier Low / Median / High Price $2,239.94 / $3,284.65 / $5,931.58	Professional		$2,239.94	$3,284.65	$5,931.58
Molina Facility/Professional Professional Modifier Low / Median / High Price $50.00 / $70.00 / $2,970.21	Professional		$50.00	$70.00	$2,970.21
Prevea360 Facility/Professional Facility Modifier Low / Median / High Price $1,407.71 / $4,122.03 / $6,264.54	Facility		$1,407.71	$4,122.03	$6,264.54
Prevea360 Facility/Professional Professional Modifier Low / Median / High Price $3,119.08 / $5,329.38 / $6,536.92	Professional		$3,119.08	$5,329.38	$6,536.92
Quartz Facility/Professional Professional Modifier Low / Median / High Price $5,447.43 / $8,341.79 / $13,083.23	Professional		$5,447.43	$8,341.79	$13,083.23
Quartz Facility/Professional Facility Modifier Low / Median / High Price $3,523.90 / $10,639.52 / $23,227.17	Facility		$3,523.90	$10,639.52	$23,227.17
Quartz Facility/Professional Professional Modifier Low / Median / High Price $2,572.44 / $3,523.90 / $26,366.97	Professional		$2,572.44	$3,523.90	$26,366.97
Security Health Facility/Professional Professional Modifier Low / Median / High Price $5,447.43 / $5,447.43 / $5,447.43	Professional		$5,447.43	$5,447.43	$5,447.43
Security Health Facility/Professional Professional Modifier Low / Median / High Price $5,447.43 / $5,447.43 / $5,447.43	Professional		$5,447.43	$5,447.43	$5,447.43
United Facility/Professional Professional Modifier Low / Median / High Price $1,970.79 / $3,281.36 / $5,447.43	Professional		$1,970.79	$3,281.36	$5,447.43