Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $14,550.37 / $14,550.37 / $14,550.37	Facility		$14,550.37	$14,550.37	$14,550.37
Aetna Facility/Professional Professional Modifier Low / Median / High Price $12,080.47 / $14,550.37 / $24,377.41	Professional		$12,080.47	$14,550.37	$24,377.41
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $28,843.34 / $31,727.67 / $52,494.88	Facility		$28,843.34	$31,727.67	$52,494.88
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $25,959.00 / $26,824.31 / $35,477.30	Professional		$25,959.00	$26,824.31	$35,477.30
CareSource Facility/Professional Facility Modifier Low / Median / High Price $20,749.84 / $61,724.75 / $61,724.75	Facility		$20,749.84	$61,724.75	$61,724.75
Cigna Facility/Professional Facility Modifier Low / Median / High Price $16,524.00 / $59,630.99 / $120,394.69	Facility		$16,524.00	$59,630.99	$120,394.69
Cigna Facility/Professional Professional Modifier Low / Median / High Price $12,062.52 / $41,797.97 / $54,588.26	Professional		$12,062.52	$41,797.97	$54,588.26
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $14,550.37 / $22,961.34 / $33,169.83	Facility		$14,550.37	$22,961.34	$33,169.83
DeanCare Facility/Professional Professional Modifier Low / Median / High Price $28,151.96 / $28,843.34 / $34,612.01	Professional		$28,151.96	$28,843.34	$34,612.01
Medica Facility/Professional Facility Modifier Low / Median / High Price $18,876.68 / $28,843.34 / $134,345.48	Facility		$18,876.68	$28,843.34	$134,345.48
Medica Facility/Professional Professional Modifier Low / Median / High Price $13,304.39 / $19,372.84 / $32,128.99	Professional		$13,304.39	$19,372.84	$32,128.99
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 $14,550.37 / $23,074.67 / $33,169.83	Facility		$14,550.37	$23,074.67	$33,169.83
Prevea360 Facility/Professional Professional Modifier Low / Median / High Price $28,151.96 / $28,843.34 / $34,612.01	Professional		$28,151.96	$28,843.34	$34,612.01
Quartz Facility/Professional Professional Modifier Low / Median / High Price $28,843.34 / $44,388.95 / $77,149.39	Professional		$28,843.34	$44,388.95	$77,149.39
Quartz Facility/Professional Facility Modifier Low / Median / High Price $16,524.00 / $56,334.64 / $134,345.48	Facility		$16,524.00	$56,334.64	$134,345.48
Quartz Facility/Professional Professional Modifier Low / Median / High Price $12,062.52 / $16,524.00 / $145,505.29	Professional		$12,062.52	$16,524.00	$145,505.29
Security Health Facility/Professional Professional Modifier Low / Median / High Price $28,843.34 / $28,843.34 / $28,843.34	Professional		$28,843.34	$28,843.34	$28,843.34
Security Health Facility/Professional Professional Modifier Low / Median / High Price $28,843.34 / $28,843.34 / $28,843.34	Professional		$28,843.34	$28,843.34	$28,843.34
United Facility/Professional Professional Modifier Low / Median / High Price $10,714.88 / $19,186.16 / $28,843.34	Professional		$10,714.88	$19,186.16	$28,843.34