Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $1,522.93 / $1,522.93 / $1,522.93	Facility		$1,522.93	$1,522.93	$1,522.93
Aetna Facility/Professional Professional Modifier Low / Median / High Price $1,264.41 / $1,522.93 / $2,551.48	Professional		$1,264.41	$1,522.93	$2,551.48
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $3,018.93 / $3,320.82 / $5,494.45	Facility		$3,018.93	$3,320.82	$5,494.45
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $2,611.06 / $2,807.60 / $3,713.28	Professional		$2,611.06	$2,807.60	$3,713.28
CareSource Facility/Professional Facility Modifier Low / Median / High Price $2,171.81 / $6,460.51 / $6,460.51	Facility		$2,171.81	$6,460.51	$6,460.51
Cigna Facility/Professional Facility Modifier Low / Median / High Price $1,952.91 / $6,665.21 / $12,601.67	Facility		$1,952.91	$6,665.21	$12,601.67
Cigna Facility/Professional Professional Modifier Low / Median / High Price $1,425.62 / $4,374.84 / $5,713.55	Professional		$1,425.62	$4,374.84	$5,713.55
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $868.59 / $2,284.40 / $3,471.77	Facility		$868.59	$2,284.40	$3,471.77
DeanCare Facility/Professional Professional Modifier Low / Median / High Price $1,728.56 / $2,946.56 / $3,622.72	Professional		$1,728.56	$2,946.56	$3,622.72
Medica Facility/Professional Facility Modifier Low / Median / High Price $1,503.58 / $3,018.93 / $14,058.21	Facility		$1,503.58	$3,018.93	$14,058.21
Medica Facility/Professional Professional Modifier Low / Median / High Price $1,378.51 / $2,017.15 / $3,287.24	Professional		$1,378.51	$2,017.15	$3,287.24
Molina Facility/Professional Professional Modifier Low / Median / High Price $50.00 / $70.00 / $2,037.32	Professional		$50.00	$70.00	$2,037.32
Prevea360 Facility/Professional Facility Modifier Low / Median / High Price $868.59 / $2,284.40 / $3,471.77	Facility		$868.59	$2,284.40	$3,471.77
Prevea360 Facility/Professional Professional Modifier Low / Median / High Price $1,728.56 / $2,946.56 / $3,622.72	Professional		$1,728.56	$2,946.56	$3,622.72
Quartz Facility/Professional Professional Modifier Low / Median / High Price $3,018.93 / $4,646.03 / $8,072.76	Professional		$3,018.93	$4,646.03	$8,072.76
Quartz Facility/Professional Facility Modifier Low / Median / High Price $1,952.91 / $5,896.34 / $14,058.21	Facility		$1,952.91	$5,896.34	$14,058.21
Quartz Facility/Professional Professional Modifier Low / Median / High Price $1,425.62 / $1,952.91 / $15,199.11	Professional		$1,425.62	$1,952.91	$15,199.11
Security Health Facility/Professional Professional Modifier Low / Median / High Price $3,018.93 / $3,018.93 / $3,018.93	Professional		$3,018.93	$3,018.93	$3,018.93
Security Health Facility/Professional Professional Modifier Low / Median / High Price $3,018.93 / $3,018.93 / $3,018.93	Professional		$3,018.93	$3,018.93	$3,018.93
United Facility/Professional Professional Modifier Low / Median / High Price $1,121.21 / $1,811.36 / $2,589.19	Professional		$1,121.21	$1,811.36	$2,589.19