Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $1,276.78 / $1,276.78 / $1,276.78	Facility		$1,276.78	$1,276.78	$1,276.78
Aetna Facility/Professional Professional Modifier Low / Median / High Price $878.64 / $1,276.78 / $2,119.94	Professional		$878.64	$1,276.78	$2,119.94
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $2,530.96 / $2,784.07 / $4,606.37	Facility		$2,530.96	$2,784.07	$4,606.37
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $2,189.03 / $2,353.80 / $3,113.09	Professional		$2,189.03	$2,353.80	$3,113.09
CareSource Facility/Professional Facility Modifier Low / Median / High Price $1,820.78 / $5,416.28 / $5,416.28	Facility		$1,820.78	$5,416.28	$5,416.28
Cigna Facility/Professional Facility Modifier Low / Median / High Price $1,637.27 / $5,232.60 / $10,563.91	Facility		$1,637.27	$5,232.60	$10,563.91
Cigna Facility/Professional Professional Modifier Low / Median / High Price $1,195.21 / $3,667.50 / $4,790.06	Professional		$1,195.21	$3,667.50	$4,790.06
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $660.62 / $1,915.17 / $2,910.62	Facility		$660.62	$1,915.17	$2,910.62
DeanCare Facility/Professional Professional Modifier Low / Median / High Price $1,449.18 / $2,530.96 / $3,037.16	Professional		$1,449.18	$2,530.96	$3,037.16
Medica Facility/Professional Facility Modifier Low / Median / High Price $1,143.56 / $2,530.96 / $10,648.17	Facility		$1,143.56	$2,530.96	$10,648.17
Medica Facility/Professional Professional Modifier Low / Median / High Price $1,140.08 / $1,541.44 / $2,755.92	Professional		$1,140.08	$1,541.44	$2,755.92
Molina Facility/Professional Professional Modifier Low / Median / High Price $50.00 / $70.00 / $1,207.33	Professional		$50.00	$70.00	$1,207.33
Prevea360 Facility/Professional Facility Modifier Low / Median / High Price $660.62 / $1,915.17 / $2,910.62	Facility		$660.62	$1,915.17	$2,910.62
Prevea360 Facility/Professional Professional Modifier Low / Median / High Price $1,449.18 / $2,530.96 / $3,037.16	Professional		$1,449.18	$2,530.96	$3,037.16
Quartz Facility/Professional Professional Modifier Low / Median / High Price $2,530.96 / $3,895.10 / $6,139.63	Professional		$2,530.96	$3,895.10	$6,139.63
Quartz Facility/Professional Facility Modifier Low / Median / High Price $1,637.27 / $4,943.30 / $10,648.17	Facility		$1,637.27	$4,943.30	$10,648.17
Quartz Facility/Professional Professional Modifier Low / Median / High Price $1,195.21 / $1,637.27 / $14,383.26	Professional		$1,195.21	$1,637.27	$14,383.26
Security Health Facility/Professional Professional Modifier Low / Median / High Price $2,530.96 / $2,530.96 / $2,530.96	Professional		$2,530.96	$2,530.96	$2,530.96
Security Health Facility/Professional Professional Modifier Low / Median / High Price $2,530.96 / $2,530.96 / $2,530.96	Professional		$2,530.96	$2,530.96	$2,530.96
United Facility/Professional Facility Modifier Low / Median / High Price $1,366.91 / $1,366.91 / $1,366.91	Facility		$1,366.91	$1,366.91	$1,366.91
United Facility/Professional Professional Modifier Low / Median / High Price $852.74 / $1,518.58 / $2,244.00	Professional		$852.74	$1,518.58	$2,244.00