Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $1,981.00 / $1,981.00 / $1,981.00	Facility		$1,981.00	$1,981.00	$1,981.00
Aetna Facility/Professional Professional Modifier Low / Median / High Price $1,644.71 / $1,981.00 / $3,318.89	Professional		$1,644.71	$1,981.00	$3,318.89
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $3,926.95 / $4,319.64 / $7,147.05	Facility		$3,926.95	$4,319.64	$7,147.05
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $3,652.06 / $3,652.06 / $4,830.14	Professional		$3,652.06	$3,652.06	$4,830.14
CareSource Facility/Professional Facility Modifier Low / Median / High Price $2,825.03 / $8,403.67 / $8,403.67	Facility		$2,825.03	$8,403.67	$8,403.67
Cigna Facility/Professional Facility Modifier Low / Median / High Price $2,540.30 / $8,669.86 / $16,391.68	Facility		$2,540.30	$8,669.86	$16,391.68
Cigna Facility/Professional Professional Modifier Low / Median / High Price $1,854.42 / $5,690.63 / $7,432.05	Professional		$1,854.42	$5,690.63	$7,432.05
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $1,129.84 / $2,971.50 / $4,515.99	Facility		$1,129.84	$2,971.50	$4,515.99
DeanCare Facility/Professional Professional Modifier Low / Median / High Price $2,248.46 / $3,832.80 / $4,712.34	Professional		$2,248.46	$3,832.80	$4,712.34
Medica Facility/Professional Facility Modifier Low / Median / High Price $1,955.82 / $3,926.95 / $18,286.54	Facility		$1,955.82	$3,926.95	$18,286.54
Medica Facility/Professional Professional Modifier Low / Median / High Price $1,793.14 / $2,623.87 / $4,275.96	Professional		$1,793.14	$2,623.87	$4,275.96
Molina Facility/Professional Professional Modifier Low / Median / High Price $50.00 / $70.00 / $2,650.11	Professional		$50.00	$70.00	$2,650.11
Prevea360 Facility/Professional Facility Modifier Low / Median / High Price $1,129.84 / $2,971.50 / $4,515.99	Facility		$1,129.84	$2,971.50	$4,515.99
Prevea360 Facility/Professional Professional Modifier Low / Median / High Price $2,248.46 / $3,832.80 / $4,712.34	Professional		$2,248.46	$3,832.80	$4,712.34
Quartz Facility/Professional Professional Modifier Low / Median / High Price $3,926.95 / $6,043.44 / $10,500.71	Professional		$3,926.95	$6,043.44	$10,500.71
Quartz Facility/Professional Facility Modifier Low / Median / High Price $2,540.30 / $7,669.82 / $18,286.54	Facility		$2,540.30	$7,669.82	$18,286.54
Quartz Facility/Professional Professional Modifier Low / Median / High Price $1,854.42 / $2,540.30 / $19,770.65	Professional		$1,854.42	$2,540.30	$19,770.65
Security Health Facility/Professional Professional Modifier Low / Median / High Price $3,926.95 / $3,926.95 / $3,926.95	Professional		$3,926.95	$3,926.95	$3,926.95
Security Health Facility/Professional Professional Modifier Low / Median / High Price $3,926.95 / $3,926.95 / $3,926.95	Professional		$3,926.95	$3,926.95	$3,926.95
United Facility/Professional Professional Modifier Low / Median / High Price $1,564.44 / $2,312.67 / $3,367.97	Professional		$1,564.44	$2,312.67	$3,367.97