Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $3,075.17 / $3,075.17 / $3,075.17	Facility		$3,075.17	$3,075.17	$3,075.17
Aetna Facility/Professional Professional Modifier Low / Median / High Price $2,188.38 / $3,075.17 / $5,105.93	Professional		$2,188.38	$3,075.17	$5,105.93
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $6,095.93 / $6,705.52 / $11,094.59	Facility		$6,095.93	$6,705.52	$11,094.59
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $5,486.33 / $5,669.21 / $7,497.99	Professional		$5,486.33	$5,669.21	$7,497.99
CareSource Facility/Professional Facility Modifier Low / Median / High Price $4,385.39 / $13,045.29 / $13,045.29	Facility		$4,385.39	$13,045.29	$13,045.29
Cigna Facility/Professional Facility Modifier Low / Median / High Price $3,943.38 / $12,603.13 / $25,445.47	Facility		$3,943.38	$12,603.13	$25,445.47
Cigna Facility/Professional Professional Modifier Low / Median / High Price $2,878.67 / $8,833.59 / $11,537.03	Professional		$2,878.67	$8,833.59	$11,537.03
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $1,691.96 / $4,612.76 / $7,010.32	Facility		$1,691.96	$4,612.76	$7,010.32
DeanCare Facility/Professional Professional Modifier Low / Median / High Price $3,490.38 / $6,095.93 / $7,315.12	Professional		$3,490.38	$6,095.93	$7,315.12
Medica Facility/Professional Facility Modifier Low / Median / High Price $2,928.84 / $6,095.93 / $27,719.31	Facility		$2,928.84	$6,095.93	$27,719.31
Medica Facility/Professional Professional Modifier Low / Median / High Price $2,673.59 / $3,947.89 / $6,637.72	Professional		$2,673.59	$3,947.89	$6,637.72
Molina Facility/Professional Professional Modifier Low / Median / High Price $50.00 / $70.00 / $2,978.83	Professional		$50.00	$70.00	$2,978.83
Prevea360 Facility/Professional Facility Modifier Low / Median / High Price $1,691.96 / $4,612.76 / $7,010.32	Facility		$1,691.96	$4,612.76	$7,010.32
Prevea360 Facility/Professional Professional Modifier Low / Median / High Price $3,490.38 / $6,095.93 / $7,315.12	Professional		$3,490.38	$6,095.93	$7,315.12
Quartz Facility/Professional Professional Modifier Low / Median / High Price $6,095.93 / $9,381.44 / $15,724.97	Professional		$6,095.93	$9,381.44	$15,724.97
Quartz Facility/Professional Facility Modifier Low / Median / High Price $3,943.38 / $11,906.12 / $27,719.31	Facility		$3,943.38	$11,906.12	$27,719.31
Quartz Facility/Professional Professional Modifier Low / Median / High Price $2,878.67 / $3,943.38 / $34,789.14	Professional		$2,878.67	$3,943.38	$34,789.14
Security Health Facility/Professional Professional Modifier Low / Median / High Price $6,095.93 / $6,095.93 / $6,095.93	Professional		$6,095.93	$6,095.93	$6,095.93
Security Health Facility/Professional Professional Modifier Low / Median / High Price $6,095.93 / $6,095.93 / $6,095.93	Professional		$6,095.93	$6,095.93	$6,095.93
United Facility/Professional Professional Modifier Low / Median / High Price $2,428.54 / $3,759.89 / $6,095.93	Professional		$2,428.54	$3,759.89	$6,095.93