Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $1,298.90 / $1,298.90 / $1,298.90	Facility		$1,298.90	$1,298.90	$1,298.90
Aetna Facility/Professional Professional Modifier Low / Median / High Price $1,271.04 / $1,298.90 / $2,564.86	Professional		$1,271.04	$1,298.90	$2,564.86
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $2,574.83 / $2,832.31 / $4,686.18	Facility		$2,574.83	$2,832.31	$4,686.18
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $2,226.96 / $2,394.59 / $3,167.04	Professional		$2,226.96	$2,394.59	$3,167.04
CareSource Facility/Professional Facility Modifier Low / Median / High Price $1,852.32 / $5,510.14 / $5,510.14	Facility		$1,852.32	$5,510.14	$5,510.14
Cigna Facility/Professional Facility Modifier Low / Median / High Price $1,665.63 / $5,323.62 / $10,747.25	Facility		$1,665.63	$5,323.62	$10,747.25
Cigna Facility/Professional Professional Modifier Low / Median / High Price $1,215.91 / $3,731.25 / $4,873.06	Professional		$1,215.91	$3,731.25	$4,873.06
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $737.03 / $1,948.35 / $2,961.05	Facility		$737.03	$1,948.35	$2,961.05
DeanCare Facility/Professional Professional Modifier Low / Median / High Price $1,474.28 / $2,532.66 / $3,089.80	Professional		$1,474.28	$2,532.66	$3,089.80
Medica Facility/Professional Facility Modifier Low / Median / High Price $1,275.83 / $2,574.83 / $12,133.56	Facility		$1,275.83	$2,574.83	$12,133.56
Medica Facility/Professional Professional Modifier Low / Median / High Price $1,156.99 / $1,718.02 / $2,803.67	Professional		$1,156.99	$1,718.02	$2,803.67
Molina Facility/Professional Professional Modifier Low / Median / High Price $50.00 / $70.00 / $1,737.62	Professional		$50.00	$70.00	$1,737.62
Prevea360 Facility/Professional Facility Modifier Low / Median / High Price $737.03 / $1,948.35 / $2,961.05	Facility		$737.03	$1,948.35	$2,961.05
Prevea360 Facility/Professional Professional Modifier Low / Median / High Price $1,474.28 / $2,532.66 / $3,089.80	Professional		$1,474.28	$2,532.66	$3,089.80
Quartz Facility/Professional Professional Modifier Low / Median / High Price $2,574.83 / $3,962.56 / $6,850.25	Professional		$2,574.83	$3,962.56	$6,850.25
Quartz Facility/Professional Facility Modifier Low / Median / High Price $1,665.63 / $5,028.96 / $12,133.56	Facility		$1,665.63	$5,028.96	$12,133.56
Quartz Facility/Professional Professional Modifier Low / Median / High Price $1,215.91 / $1,665.63 / $14,645.71	Professional		$1,215.91	$1,665.63	$14,645.71
Security Health Facility/Professional Professional Modifier Low / Median / High Price $2,574.83 / $2,574.83 / $2,574.83	Professional		$2,574.83	$2,574.83	$2,574.83
Security Health Facility/Professional Professional Modifier Low / Median / High Price $2,574.83 / $2,574.83 / $2,574.83	Professional		$2,574.83	$2,574.83	$2,574.83
United Facility/Professional Professional Modifier Low / Median / High Price $1,025.78 / $1,508.62 / $2,208.32	Professional		$1,025.78	$1,508.62	$2,208.32