Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $2,961.84 / $2,961.84 / $2,961.84	Facility		$2,961.84	$2,961.84	$2,961.84
Aetna Facility/Professional Professional Modifier Low / Median / High Price $1,958.42 / $2,961.84 / $4,917.77	Professional		$1,958.42	$2,961.84	$4,917.77
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $5,871.29 / $6,458.42 / $10,685.75	Facility		$5,871.29	$6,458.42	$10,685.75
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $5,460.30 / $5,460.30 / $7,221.68	Professional		$5,460.30	$5,460.30	$7,221.68
CareSource Facility/Professional Facility Modifier Low / Median / High Price $4,223.79 / $12,564.56 / $12,564.56	Facility		$4,223.79	$12,564.56	$12,564.56
Cigna Facility/Professional Facility Modifier Low / Median / High Price $3,798.08 / $12,138.78 / $24,507.77	Facility		$3,798.08	$12,138.78	$24,507.77
Cigna Facility/Professional Professional Modifier Low / Median / High Price $2,772.60 / $8,508.28 / $11,111.88	Professional		$2,772.60	$8,508.28	$11,111.88
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $1,514.15 / $4,442.76 / $6,751.98	Facility		$1,514.15	$4,442.76	$6,751.98
DeanCare Facility/Professional Professional Modifier Low / Median / High Price $3,361.76 / $5,871.29 / $7,045.55	Professional		$3,361.76	$5,871.29	$7,045.55
Medica Facility/Professional Facility Modifier Low / Median / High Price $2,621.06 / $5,871.29 / $24,802.46	Facility		$2,621.06	$5,871.29	$24,802.46
Medica Facility/Professional Professional Modifier Low / Median / High Price $2,644.74 / $3,533.03 / $6,393.11	Professional		$2,644.74	$3,533.03	$6,393.11
Molina Facility/Professional Professional Modifier Low / Median / High Price $50.00 / $70.00 / $1,818.94	Professional		$50.00	$70.00	$1,818.94
Prevea360 Facility/Professional Facility Modifier Low / Median / High Price $1,514.15 / $4,442.76 / $6,751.98	Facility		$1,514.15	$4,442.76	$6,751.98
Prevea360 Facility/Professional Professional Modifier Low / Median / High Price $3,361.76 / $5,871.29 / $7,045.55	Professional		$3,361.76	$5,871.29	$7,045.55
Quartz Facility/Professional Professional Modifier Low / Median / High Price $5,871.29 / $8,973.15 / $14,072.88	Professional		$5,871.29	$8,973.15	$14,072.88
Quartz Facility/Professional Facility Modifier Low / Median / High Price $3,798.08 / $11,467.36 / $24,802.46	Facility		$3,798.08	$11,467.36	$24,802.46
Quartz Facility/Professional Professional Modifier Low / Median / High Price $2,772.60 / $3,798.08 / $31,028.33	Professional		$2,772.60	$3,798.08	$31,028.33
Security Health Facility/Professional Professional Modifier Low / Median / High Price $5,871.29 / $5,871.29 / $5,871.29	Professional		$5,871.29	$5,871.29	$5,871.29
Security Health Facility/Professional Professional Modifier Low / Median / High Price $5,871.29 / $5,871.29 / $5,871.29	Professional		$5,871.29	$5,871.29	$5,871.29
United Facility/Professional Professional Modifier Low / Median / High Price $1,954.51 / $3,529.49 / $5,205.58	Professional		$1,954.51	$3,529.49	$5,205.58