Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $2,703.17 / $2,703.17 / $2,703.17	Facility		$2,703.17	$2,703.17	$2,703.17
Aetna Facility/Professional Professional Modifier Low / Median / High Price $1,862.77 / $2,703.17 / $4,488.29	Professional		$1,862.77	$2,703.17	$4,488.29
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $5,358.53 / $5,894.38 / $9,752.52	Facility		$5,358.53	$5,894.38	$9,752.52
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $4,822.67 / $4,983.43 / $6,590.99	Professional		$4,822.67	$4,983.43	$6,590.99
CareSource Facility/Professional Facility Modifier Low / Median / High Price $3,854.92 / $11,467.25 / $11,467.25	Facility		$3,854.92	$11,467.25	$11,467.25
Cigna Facility/Professional Facility Modifier Low / Median / High Price $3,813.78 / $11,078.73 / $22,366.43	Facility		$3,813.78	$11,078.73	$22,366.43
Cigna Facility/Professional Professional Modifier Low / Median / High Price $2,784.06 / $7,765.31 / $10,141.44	Professional		$2,784.06	$7,765.31	$10,141.44
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $1,440.20 / $4,054.76 / $6,162.31	Facility		$1,440.20	$4,054.76	$6,162.31
DeanCare Facility/Professional Professional Modifier Low / Median / High Price $3,068.18 / $5,358.53 / $6,430.24	Professional		$3,068.18	$5,358.53	$6,430.24
Medica Facility/Professional Facility Modifier Low / Median / High Price $2,493.05 / $5,358.53 / $23,822.60	Facility		$2,493.05	$5,358.53	$23,822.60
Medica Facility/Professional Professional Modifier Low / Median / High Price $2,413.77 / $3,360.47 / $5,834.78	Professional		$2,413.77	$3,360.47	$5,834.78
Molina Facility/Professional Professional Modifier Low / Median / High Price $50.00 / $70.00 / $1,697.68	Professional		$50.00	$70.00	$1,697.68
Prevea360 Facility/Professional Facility Modifier Low / Median / High Price $1,440.20 / $4,054.76 / $6,162.31	Facility		$1,440.20	$4,054.76	$6,162.31
Prevea360 Facility/Professional Professional Modifier Low / Median / High Price $3,068.18 / $5,358.53 / $6,430.24	Professional		$3,068.18	$5,358.53	$6,430.24
Quartz Facility/Professional Professional Modifier Low / Median / High Price $5,358.53 / $8,246.60 / $13,385.34	Professional		$5,358.53	$8,246.60	$13,385.34
Quartz Facility/Professional Facility Modifier Low / Median / High Price $3,813.78 / $10,465.87 / $23,822.60	Facility		$3,813.78	$10,465.87	$23,822.60
Quartz Facility/Professional Professional Modifier Low / Median / High Price $2,784.06 / $3,813.78 / $28,618.56	Professional		$2,784.06	$3,813.78	$28,618.56
Security Health Facility/Professional Professional Modifier Low / Median / High Price $5,358.53 / $5,358.53 / $5,358.53	Professional		$5,358.53	$5,358.53	$5,358.53
Security Health Facility/Professional Professional Modifier Low / Median / High Price $5,358.53 / $5,358.53 / $5,358.53	Professional		$5,358.53	$5,358.53	$5,358.53
United Facility/Professional Professional Modifier Low / Median / High Price $2,016.28 / $3,215.12 / $5,358.53	Professional		$2,016.28	$3,215.12	$5,358.53