Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $1,032.63 / $1,032.63 / $1,032.63	Facility		$1,032.63	$1,032.63	$1,032.63
Aetna Facility/Professional Professional Modifier Low / Median / High Price $756.72 / $1,032.63 / $1,714.56	Professional		$756.72	$1,032.63	$1,714.56
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $2,047.00 / $2,251.69 / $3,725.54	Facility		$2,047.00	$2,251.69	$3,725.54
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $1,842.30 / $1,903.71 / $2,517.81	Professional		$1,842.30	$1,903.71	$2,517.81
CareSource Facility/Professional Facility Modifier Low / Median / High Price $1,472.60 / $4,380.58 / $4,380.58	Facility		$1,472.60	$4,380.58	$4,380.58
Cigna Facility/Professional Facility Modifier Low / Median / High Price $1,324.18 / $4,231.68 / $8,544.34	Facility		$1,324.18	$4,231.68	$8,544.34
Cigna Facility/Professional Professional Modifier Low / Median / High Price $966.65 / $2,966.25 / $3,874.10	Professional		$966.65	$2,966.25	$3,874.10
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $532.04 / $1,548.95 / $2,354.05	Facility		$532.04	$1,548.95	$2,354.05
DeanCare Facility/Professional Professional Modifier Low / Median / High Price $1,172.06 / $1,651.91 / $2,456.40	Professional		$1,172.06	$1,651.91	$2,456.40
Medica Facility/Professional Facility Modifier Low / Median / High Price $920.97 / $2,047.00 / $8,608.62	Facility		$920.97	$2,047.00	$8,608.62
Medica Facility/Professional Professional Modifier Low / Median / High Price $856.34 / $1,241.41 / $2,228.92	Professional		$856.34	$1,241.41	$2,228.92
Molina Facility/Professional Professional Modifier Low / Median / High Price $50.00 / $70.00 / $1,381.43	Professional		$50.00	$70.00	$1,381.43
Prevea360 Facility/Professional Facility Modifier Low / Median / High Price $532.04 / $1,548.95 / $2,354.05	Facility		$532.04	$1,548.95	$2,354.05
Prevea360 Facility/Professional Professional Modifier Low / Median / High Price $1,172.06 / $1,651.91 / $2,456.40	Professional		$1,172.06	$1,651.91	$2,456.40
Quartz Facility/Professional Professional Modifier Low / Median / High Price $2,047.00 / $3,150.26 / $4,945.22	Professional		$2,047.00	$3,150.26	$4,945.22
Quartz Facility/Professional Facility Modifier Low / Median / High Price $1,324.18 / $3,998.04 / $8,608.62	Facility		$1,324.18	$3,998.04	$8,608.62
Quartz Facility/Professional Professional Modifier Low / Median / High Price $966.65 / $1,324.18 / $10,968.65	Professional		$966.65	$1,324.18	$10,968.65
Security Health Facility/Professional Professional Modifier Low / Median / High Price $2,047.00 / $2,047.00 / $2,047.00	Professional		$2,047.00	$2,047.00	$2,047.00
Security Health Facility/Professional Professional Modifier Low / Median / High Price $2,047.00 / $2,047.00 / $2,047.00	Professional		$2,047.00	$2,047.00	$2,047.00
United Facility/Professional Facility Modifier Low / Median / High Price $640.00 / $640.00 / $640.00	Facility		$640.00	$640.00	$640.00
United Facility/Professional Professional Modifier Low / Median / High Price $686.77 / $1,228.20 / $1,755.62	Professional		$686.77	$1,228.20	$1,755.62