Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $2,293.52 / $2,293.52 / $2,293.52	Facility		$2,293.52	$2,293.52	$2,293.52
Aetna Facility/Professional Professional Modifier Low / Median / High Price $1,904.18 / $2,293.52 / $3,842.49	Professional		$1,904.18	$2,293.52	$3,842.49
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $4,546.46 / $5,001.10 / $8,274.56	Facility		$4,546.46	$5,001.10	$8,274.56
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $4,180.84 / $4,228.21 / $5,592.14	Professional		$4,180.84	$4,228.21	$5,592.14
CareSource Facility/Professional Facility Modifier Low / Median / High Price $3,270.71 / $9,729.42 / $9,729.42	Facility		$3,270.71	$9,729.42	$9,729.42
Cigna Facility/Professional Facility Modifier Low / Median / High Price $2,941.06 / $10,038.39 / $18,976.68	Facility		$2,941.06	$10,038.39	$18,976.68
Cigna Facility/Professional Professional Modifier Low / Median / High Price $2,146.96 / $7,571.98 / $8,604.53	Professional		$2,146.96	$7,571.98	$8,604.53
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $1,308.09 / $3,637.17 / $5,228.43	Facility		$1,308.09	$3,637.17	$5,228.43
DeanCare Facility/Professional Professional Modifier Low / Median / High Price $2,603.19 / $4,437.52 / $5,455.75	Professional		$2,603.19	$4,437.52	$5,455.75
Medica Facility/Professional Facility Modifier Low / Median / High Price $2,293.52 / $4,546.46 / $21,171.57	Facility		$2,293.52	$4,546.46	$21,171.57
Medica Facility/Professional Professional Modifier Low / Median / High Price $2,086.84 / $3,049.19 / $4,950.53	Professional		$2,086.84	$3,049.19	$4,950.53
Molina Facility/Professional Professional Modifier Low / Median / High Price $50.00 / $65.00 / $85.00	Professional		$50.00	$65.00	$85.00
Prevea360 Facility/Professional Facility Modifier Low / Median / High Price $1,308.09 / $3,637.17 / $5,228.43	Facility		$1,308.09	$3,637.17	$5,228.43
Prevea360 Facility/Professional Professional Modifier Low / Median / High Price $2,603.19 / $4,437.52 / $5,455.75	Professional		$2,603.19	$4,437.52	$5,455.75
Quartz Facility/Professional Professional Modifier Low / Median / High Price $4,546.46 / $6,996.86 / $12,157.82	Professional		$4,546.46	$6,996.86	$12,157.82
Quartz Facility/Professional Facility Modifier Low / Median / High Price $2,941.06 / $8,879.79 / $21,171.57	Facility		$2,941.06	$8,879.79	$21,171.57
Quartz Facility/Professional Professional Modifier Low / Median / High Price $2,146.96 / $2,941.06 / $22,889.87	Professional		$2,146.96	$2,941.06	$22,889.87
Security Health Facility/Professional Professional Modifier Low / Median / High Price $4,546.46 / $4,546.46 / $4,546.46	Professional		$4,546.46	$4,546.46	$4,546.46
Security Health Facility/Professional Professional Modifier Low / Median / High Price $4,546.46 / $4,546.46 / $4,546.46	Professional		$4,546.46	$4,546.46	$4,546.46
United Facility/Professional Professional Modifier Low / Median / High Price $1,586.52 / $2,701.65 / $4,950.53	Professional		$1,586.52	$2,701.65	$4,950.53