Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $1,657.15 / $1,657.15 / $1,657.15	Facility		$1,657.15	$1,657.15	$1,657.15
Aetna Facility/Professional Professional Modifier Low / Median / High Price $1,160.17 / $1,657.15 / $2,751.49	Professional		$1,160.17	$1,657.15	$2,751.49
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $3,284.97 / $3,613.47 / $5,978.65	Facility		$3,284.97	$3,613.47	$5,978.65
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $2,956.47 / $3,055.02 / $4,040.51	Professional		$2,956.47	$3,055.02	$4,040.51
CareSource Facility/Professional Facility Modifier Low / Median / High Price $2,363.21 / $7,029.84 / $7,029.84	Facility		$2,363.21	$7,029.84	$7,029.84
Cigna Facility/Professional Facility Modifier Low / Median / High Price $2,125.02 / $6,791.70 / $13,711.53	Facility		$2,125.02	$6,791.70	$13,711.53
Cigna Facility/Professional Professional Modifier Low / Median / High Price $1,551.26 / $4,760.16 / $6,217.06	Professional		$1,551.26	$4,760.16	$6,217.06
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $896.99 / $2,485.73 / $3,777.72	Facility		$896.99	$2,485.73	$3,777.72
DeanCare Facility/Professional Professional Modifier Low / Median / High Price $1,880.90 / $3,284.97 / $3,941.96	Professional		$1,880.90	$3,284.97	$3,941.96
Medica Facility/Professional Facility Modifier Low / Median / High Price $1,552.72 / $3,284.97 / $14,520.96	Facility		$1,552.72	$3,284.97	$14,520.96
Medica Facility/Professional Professional Modifier Low / Median / High Price $1,479.73 / $2,092.96 / $3,576.93	Professional		$1,479.73	$2,092.96	$3,576.93
Molina Facility/Professional Professional Modifier Low / Median / High Price $50.00 / $70.00 / $1,581.68	Professional		$50.00	$70.00	$1,581.68
Prevea360 Facility/Professional Facility Modifier Low / Median / High Price $896.99 / $2,485.73 / $3,777.72	Facility		$896.99	$2,485.73	$3,777.72
Prevea360 Facility/Professional Professional Modifier Low / Median / High Price $1,880.90 / $3,284.97 / $3,941.96	Professional		$1,880.90	$3,284.97	$3,941.96
Quartz Facility/Professional Professional Modifier Low / Median / High Price $3,284.97 / $5,055.49 / $8,336.73	Professional		$3,284.97	$5,055.49	$8,336.73
Quartz Facility/Professional Facility Modifier Low / Median / High Price $2,125.02 / $6,415.96 / $14,520.96	Facility		$2,125.02	$6,415.96	$14,520.96
Quartz Facility/Professional Professional Modifier Low / Median / High Price $1,551.26 / $2,125.02 / $18,492.63	Professional		$1,551.26	$2,125.02	$18,492.63
Security Health Facility/Professional Professional Modifier Low / Median / High Price $3,284.97 / $3,284.97 / $3,284.97	Professional		$3,284.97	$3,284.97	$3,284.97
Security Health Facility/Professional Professional Modifier Low / Median / High Price $3,284.97 / $3,284.97 / $3,284.97	Professional		$3,284.97	$3,284.97	$3,284.97
United Facility/Professional Professional Modifier Low / Median / High Price $1,157.85 / $1,970.98 / $3,284.97	Professional		$1,157.85	$1,970.98	$3,284.97