Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $2,489.73 / $2,489.73 / $2,489.73	Facility		$2,489.73	$2,489.73	$2,489.73
Aetna Facility/Professional Professional Modifier Low / Median / High Price $2,067.07 / $2,489.73 / $4,171.18	Professional		$2,067.07	$2,489.73	$4,171.18
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $4,935.41 / $5,428.95 / $8,982.45	Facility		$4,935.41	$5,428.95	$8,982.45
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $4,268.63 / $4,589.93 / $6,070.55	Professional		$4,268.63	$4,589.93	$6,070.55
CareSource Facility/Professional Facility Modifier Low / Median / High Price $3,550.52 / $10,561.78 / $10,561.78	Facility		$3,550.52	$10,561.78	$10,561.78
Cigna Facility/Professional Facility Modifier Low / Median / High Price $2,801.20 / $10,896.95 / $20,600.18	Facility		$2,801.20	$10,896.95	$20,600.18
Cigna Facility/Professional Professional Modifier Low / Median / High Price $2,044.88 / $8,219.77 / $9,340.65	Professional		$2,044.88	$8,219.77	$9,340.65
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $1,420.00 / $3,734.60 / $5,675.72	Facility		$1,420.00	$3,734.60	$5,675.72
DeanCare Facility/Professional Professional Modifier Low / Median / High Price $2,825.89 / $4,817.09 / $5,922.49	Professional		$2,825.89	$4,817.09	$5,922.49
Medica Facility/Professional Facility Modifier Low / Median / High Price $2,458.07 / $4,935.41 / $22,982.54	Facility		$2,458.07	$4,935.41	$22,982.54
Medica Facility/Professional Professional Modifier Low / Median / High Price $2,229.10 / $3,297.69 / $5,374.05	Professional		$2,229.10	$3,297.69	$5,374.05
Molina Facility/Professional Professional Modifier Low / Median / High Price $50.00 / $70.00 / $2,634.89	Professional		$50.00	$70.00	$2,634.89
Prevea360 Facility/Professional Facility Modifier Low / Median / High Price $1,420.00 / $3,734.60 / $5,675.72	Facility		$1,420.00	$3,734.60	$5,675.72
Prevea360 Facility/Professional Professional Modifier Low / Median / High Price $2,825.89 / $4,817.09 / $5,922.49	Professional		$2,825.89	$4,817.09	$5,922.49
Quartz Facility/Professional Professional Modifier Low / Median / High Price $4,935.41 / $7,595.44 / $13,197.65	Professional		$4,935.41	$7,595.44	$13,197.65
Quartz Facility/Professional Facility Modifier Low / Median / High Price $2,801.20 / $9,639.48 / $22,982.54	Facility		$2,801.20	$9,639.48	$22,982.54
Quartz Facility/Professional Professional Modifier Low / Median / High Price $2,044.88 / $2,801.20 / $24,847.51	Professional		$2,044.88	$2,801.20	$24,847.51
Security Health Facility/Professional Professional Modifier Low / Median / High Price $4,935.41 / $4,935.41 / $4,935.41	Professional		$4,935.41	$4,935.41	$4,935.41
Security Health Facility/Professional Professional Modifier Low / Median / High Price $4,935.41 / $4,935.41 / $4,935.41	Professional		$4,935.41	$4,935.41	$4,935.41
United Facility/Professional Professional Modifier Low / Median / High Price $1,832.97 / $3,282.96 / $4,232.89	Professional		$1,832.97	$3,282.96	$4,232.89