Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $1,234.77 / $1,234.77 / $1,234.77	Facility		$1,234.77	$1,234.77	$1,234.77
Aetna Facility/Professional Professional Modifier Low / Median / High Price $1,025.17 / $1,234.77 / $2,068.71	Professional		$1,025.17	$1,234.77	$2,068.71
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $2,447.69 / $2,692.46 / $4,454.80	Facility		$2,447.69	$2,692.46	$4,454.80
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $2,202.92 / $2,276.35 / $3,010.65	Professional		$2,202.92	$2,276.35	$3,010.65
CareSource Facility/Professional Facility Modifier Low / Median / High Price $1,760.87 / $5,238.06 / $5,238.06	Facility		$1,760.87	$5,238.06	$5,238.06
Cigna Facility/Professional Facility Modifier Low / Median / High Price $1,366.32 / $5,403.90 / $10,216.82	Facility		$1,366.32	$5,403.90	$10,216.82
Cigna Facility/Professional Professional Modifier Low / Median / High Price $997.41 / $3,603.78 / $4,632.43	Professional		$997.41	$3,603.78	$4,632.43
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $739.46 / $1,958.15 / $2,814.84	Facility		$739.46	$1,958.15	$2,814.84
DeanCare Facility/Professional Professional Modifier Low / Median / High Price $2,389.03 / $2,447.69 / $2,937.23	Professional		$2,389.03	$2,447.69	$2,937.23
Medica Facility/Professional Facility Modifier Low / Median / High Price $1,234.77 / $2,447.69 / $11,410.07	Facility		$1,234.77	$2,447.69	$11,410.07
Medica Facility/Professional Professional Modifier Low / Median / High Price $1,123.51 / $1,641.60 / $2,679.28	Professional		$1,123.51	$1,641.60	$2,679.28
Molina Facility/Professional Professional Modifier Low / Median / High Price $50.00 / $70.00 / $1,447.23	Professional		$50.00	$70.00	$1,447.23
Prevea360 Facility/Professional Facility Modifier Low / Median / High Price $739.46 / $1,958.15 / $2,814.84	Facility		$739.46	$1,958.15	$2,814.84
Prevea360 Facility/Professional Professional Modifier Low / Median / High Price $2,389.03 / $2,447.69 / $2,937.23	Professional		$2,389.03	$2,447.69	$2,937.23
Quartz Facility/Professional Professional Modifier Low / Median / High Price $2,447.69 / $3,766.93 / $6,545.13	Professional		$2,447.69	$3,766.93	$6,545.13
Quartz Facility/Professional Facility Modifier Low / Median / High Price $1,366.32 / $4,780.64 / $11,410.07	Facility		$1,366.32	$4,780.64	$11,410.07
Quartz Facility/Professional Professional Modifier Low / Median / High Price $997.41 / $1,366.32 / $12,323.41	Professional		$997.41	$1,366.32	$12,323.41
Security Health Facility/Professional Professional Modifier Low / Median / High Price $2,447.69 / $2,447.69 / $2,447.69	Professional		$2,447.69	$2,447.69	$2,447.69
Security Health Facility/Professional Professional Modifier Low / Median / High Price $2,447.69 / $2,447.69 / $2,447.69	Professional		$2,447.69	$2,447.69	$2,447.69
United Facility/Professional Professional Modifier Low / Median / High Price $975.13 / $1,468.61 / $2,447.69	Professional		$975.13	$1,468.61	$2,447.69