Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $2,449.85 / $2,449.85 / $2,449.85	Facility		$2,449.85	$2,449.85	$2,449.85
Aetna Facility/Professional Professional Modifier Low / Median / High Price $1,608.42 / $2,449.85 / $4,067.67	Professional		$1,608.42	$2,449.85	$4,067.67
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $4,856.35 / $5,341.99 / $8,838.56	Facility		$4,856.35	$5,341.99	$8,838.56
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $4,200.26 / $4,516.41 / $5,973.31	Professional		$4,200.26	$4,516.41	$5,973.31
CareSource Facility/Professional Facility Modifier Low / Median / High Price $3,493.65 / $10,392.59 / $10,392.59	Facility		$3,493.65	$10,392.59	$10,392.59
Cigna Facility/Professional Facility Modifier Low / Median / High Price $3,141.52 / $10,040.27 / $20,271.29	Facility		$3,141.52	$10,040.27	$20,271.29
Cigna Facility/Professional Professional Modifier Low / Median / High Price $2,293.31 / $7,037.34 / $9,191.03	Professional		$2,293.31	$7,037.34	$9,191.03
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $1,173.07 / $3,674.78 / $5,584.80	Facility		$1,173.07	$3,674.78	$5,584.80
DeanCare Facility/Professional Professional Modifier Low / Median / High Price $2,780.62 / $4,856.35 / $5,827.62	Professional		$2,780.62	$4,856.35	$5,827.62
Medica Facility/Professional Facility Modifier Low / Median / High Price $2,030.64 / $4,844.28 / $18,963.50	Facility		$2,030.64	$4,844.28	$18,963.50
Medica Facility/Professional Professional Modifier Low / Median / High Price $2,100.05 / $2,737.79 / $5,287.97	Professional		$2,100.05	$2,737.79	$5,287.97
Molina Facility/Professional Professional Modifier Low / Median / High Price $50.00 / $70.00 / $1,977.10	Professional		$50.00	$70.00	$1,977.10
Prevea360 Facility/Professional Facility Modifier Low / Median / High Price $1,173.07 / $3,674.78 / $5,584.80	Facility		$1,173.07	$3,674.78	$5,584.80
Prevea360 Facility/Professional Professional Modifier Low / Median / High Price $2,780.62 / $4,856.35 / $5,827.62	Professional		$2,780.62	$4,856.35	$5,827.62
Quartz Facility/Professional Professional Modifier Low / Median / High Price $4,856.35 / $7,284.53 / $10,903.19	Professional		$4,856.35	$7,284.53	$10,903.19
Quartz Facility/Professional Facility Modifier Low / Median / High Price $3,141.52 / $9,485.06 / $18,963.50	Facility		$3,141.52	$9,485.06	$18,963.50
Quartz Facility/Professional Professional Modifier Low / Median / High Price $2,293.31 / $3,141.52 / $23,310.48	Professional		$2,293.31	$3,141.52	$23,310.48
Security Health Facility/Professional Professional Modifier Low / Median / High Price $4,856.35 / $4,856.35 / $4,856.35	Professional		$4,856.35	$4,856.35	$4,856.35
Security Health Facility/Professional Professional Modifier Low / Median / High Price $4,856.35 / $4,856.35 / $4,856.35	Professional		$4,856.35	$4,856.35	$4,856.35
United Facility/Professional Professional Modifier Low / Median / High Price $1,615.18 / $2,422.78 / $4,542.71	Professional		$1,615.18	$2,422.78	$4,542.71