Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $1,891.17 / $1,891.17 / $1,891.17	Facility		$1,891.17	$1,891.17	$1,891.17
Aetna Facility/Professional Professional Modifier Low / Median / High Price $1,386.10 / $1,891.17 / $3,140.05	Professional		$1,386.10	$1,891.17	$3,140.05
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $3,748.87 / $4,123.76 / $6,822.94	Facility		$3,748.87	$4,123.76	$6,822.94
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $3,373.98 / $3,486.45 / $4,611.10	Professional		$3,373.98	$3,486.45	$4,611.10
CareSource Facility/Professional Facility Modifier Low / Median / High Price $2,696.94 / $8,022.58 / $8,022.58	Facility		$2,696.94	$8,022.58	$8,022.58
Cigna Facility/Professional Facility Modifier Low / Median / High Price $2,425.11 / $7,750.44 / $15,648.53	Facility		$2,425.11	$7,750.44	$15,648.53
Cigna Facility/Professional Professional Modifier Low / Median / High Price $1,770.33 / $5,432.81 / $7,095.04	Professional		$1,770.33	$5,432.81	$7,095.04
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $1,017.02 / $2,836.76 / $4,311.20	Facility		$1,017.02	$2,836.76	$4,311.20
DeanCare Facility/Professional Professional Modifier Low / Median / High Price $2,146.52 / $3,409.89 / $4,498.64	Professional		$2,146.52	$3,409.89	$4,498.64
Medica Facility/Professional Facility Modifier Low / Median / High Price $1,760.50 / $3,748.87 / $16,380.05	Facility		$1,760.50	$3,748.87	$16,380.05
Medica Facility/Professional Professional Modifier Low / Median / High Price $1,607.50 / $2,373.05 / $4,082.07	Professional		$1,607.50	$2,373.05	$4,082.07
Molina Facility/Professional Professional Modifier Low / Median / High Price $50.00 / $70.00 / $2,104.87	Professional		$50.00	$70.00	$2,104.87
Prevea360 Facility/Professional Facility Modifier Low / Median / High Price $1,017.02 / $2,836.76 / $4,311.20	Facility		$1,017.02	$2,836.76	$4,311.20
Prevea360 Facility/Professional Professional Modifier Low / Median / High Price $2,146.52 / $3,409.89 / $4,498.64	Professional		$2,146.52	$3,409.89	$4,498.64
Quartz Facility/Professional Professional Modifier Low / Median / High Price $3,748.87 / $5,769.40 / $9,452.85	Professional		$3,748.87	$5,769.40	$9,452.85
Quartz Facility/Professional Facility Modifier Low / Median / High Price $2,425.11 / $7,322.02 / $16,380.05	Facility		$2,425.11	$7,322.02	$16,380.05
Quartz Facility/Professional Professional Modifier Low / Median / High Price $1,770.33 / $2,425.11 / $19,267.33	Professional		$1,770.33	$2,425.11	$19,267.33
Security Health Facility/Professional Professional Modifier Low / Median / High Price $3,748.87 / $3,748.87 / $3,748.87	Professional		$3,748.87	$3,748.87	$3,748.87
Security Health Facility/Professional Professional Modifier Low / Median / High Price $2,993.39 / $3,748.87 / $3,748.87	Professional		$2,993.39	$3,748.87	$3,748.87
United Facility/Professional Professional Modifier Low / Median / High Price $1,246.84 / $1,870.28 / $3,215.26	Professional		$1,246.84	$1,870.28	$3,215.26