Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $1,959.85 / $1,959.85 / $1,959.85	Facility		$1,959.85	$1,959.85	$1,959.85
Aetna Facility/Professional Professional Modifier Low / Median / High Price $1,429.17 / $1,959.85 / $3,254.09	Professional		$1,429.17	$1,959.85	$3,254.09
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $3,885.03 / $4,273.53 / $7,070.75	Facility		$3,885.03	$4,273.53	$7,070.75
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $3,360.16 / $3,613.08 / $4,778.58	Professional		$3,360.16	$3,613.08	$4,778.58
CareSource Facility/Professional Facility Modifier Low / Median / High Price $2,794.88 / $8,313.95 / $8,313.95	Facility		$2,794.88	$8,313.95	$8,313.95
Cigna Facility/Professional Facility Modifier Low / Median / High Price $2,561.34 / $8,031.84 / $16,216.75	Facility		$2,561.34	$8,031.84	$16,216.75
Cigna Facility/Professional Professional Modifier Low / Median / High Price $1,869.78 / $5,629.69 / $7,352.71	Professional		$1,869.78	$5,629.69	$7,352.71
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $1,038.06 / $2,939.78 / $4,467.78	Facility		$1,038.06	$2,939.78	$4,467.78
DeanCare Facility/Professional Professional Modifier Low / Median / High Price $2,224.48 / $3,885.03 / $4,662.04	Professional		$2,224.48	$3,885.03	$4,662.04
Medica Facility/Professional Facility Modifier Low / Median / High Price $1,796.94 / $3,885.03 / $16,910.75	Facility		$1,796.94	$3,885.03	$16,910.75
Medica Facility/Professional Professional Modifier Low / Median / High Price $1,750.03 / $2,422.15 / $4,230.32	Professional		$1,750.03	$2,422.15	$4,230.32
Molina Facility/Professional Professional Modifier Low / Median / High Price $50.00 / $70.00 / $1,455.16	Professional		$50.00	$70.00	$1,455.16
Prevea360 Facility/Professional Facility Modifier Low / Median / High Price $1,038.06 / $2,939.78 / $4,467.78	Facility		$1,038.06	$2,939.78	$4,467.78
Prevea360 Facility/Professional Professional Modifier Low / Median / High Price $2,224.48 / $3,885.03 / $4,662.04	Professional		$2,224.48	$3,885.03	$4,662.04
Quartz Facility/Professional Professional Modifier Low / Median / High Price $3,885.03 / $5,978.93 / $9,647.56	Professional		$3,885.03	$5,978.93	$9,647.56
Quartz Facility/Professional Facility Modifier Low / Median / High Price $2,561.34 / $7,587.94 / $16,910.75	Facility		$2,561.34	$7,587.94	$16,910.75
Quartz Facility/Professional Professional Modifier Low / Median / High Price $1,869.78 / $2,561.34 / $21,294.00	Professional		$1,869.78	$2,561.34	$21,294.00
Security Health Facility/Professional Professional Modifier Low / Median / High Price $3,885.03 / $3,885.03 / $3,885.03	Professional		$3,885.03	$3,885.03	$3,885.03
Security Health Facility/Professional Professional Modifier Low / Median / High Price $3,885.03 / $3,885.03 / $3,885.03	Professional		$3,885.03	$3,885.03	$3,885.03
United Facility/Professional Professional Modifier Low / Median / High Price $1,339.96 / $2,331.02 / $3,761.30	Professional		$1,339.96	$2,331.02	$3,761.30