Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $2,571.40 / $2,571.40 / $2,571.40	Facility		$2,571.40	$2,571.40	$2,571.40
Aetna Facility/Professional Professional Modifier Low / Median / High Price $1,761.29 / $2,571.40 / $4,269.50	Professional		$1,761.29	$2,571.40	$4,269.50
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $5,097.31 / $5,607.04 / $9,277.10	Facility		$5,097.31	$5,607.04	$9,277.10
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $4,587.57 / $4,740.50 / $6,269.69	Professional		$4,587.57	$4,740.50	$6,269.69
CareSource Facility/Professional Facility Modifier Low / Median / High Price $3,667.00 / $10,908.24 / $10,908.24	Facility		$3,667.00	$10,908.24	$10,908.24
Cigna Facility/Professional Facility Modifier Low / Median / High Price $3,297.39 / $11,254.62 / $21,276.17	Facility		$3,297.39	$11,254.62	$21,276.17
Cigna Facility/Professional Professional Modifier Low / Median / High Price $2,407.09 / $7,504.75 / $9,647.08	Professional		$2,407.09	$7,504.75	$9,647.08
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $1,231.29 / $3,857.10 / $5,861.91	Facility		$1,231.29	$3,857.10	$5,861.91
DeanCare Facility/Professional Professional Modifier Low / Median / High Price $2,918.60 / $5,097.31 / $6,116.77	Professional		$2,918.60	$5,097.31	$6,116.77
Medica Facility/Professional Facility Modifier Low / Median / High Price $2,131.40 / $5,086.62 / $19,929.31	Facility		$2,131.40	$5,086.62	$19,929.31
Medica Facility/Professional Professional Modifier Low / Median / High Price $2,030.70 / $2,873.64 / $5,550.34	Professional		$2,030.70	$2,873.64	$5,550.34
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 $1,231.29 / $3,857.10 / $5,861.91	Facility		$1,231.29	$3,857.10	$5,861.91
Prevea360 Facility/Professional Professional Modifier Low / Median / High Price $2,918.60 / $5,097.31 / $6,116.77	Professional		$2,918.60	$5,097.31	$6,116.77
Quartz Facility/Professional Professional Modifier Low / Median / High Price $5,097.31 / $7,645.97 / $11,444.19	Professional		$5,097.31	$7,645.97	$11,444.19
Quartz Facility/Professional Facility Modifier Low / Median / High Price $3,297.39 / $9,955.70 / $19,929.31	Facility		$3,297.39	$9,955.70	$19,929.31
Quartz Facility/Professional Professional Modifier Low / Median / High Price $2,407.09 / $3,297.39 / $30,066.71	Professional		$2,407.09	$3,297.39	$30,066.71
Security Health Facility/Professional Professional Modifier Low / Median / High Price $5,097.31 / $5,097.31 / $5,097.31	Professional		$5,097.31	$5,097.31	$5,097.31
Security Health Facility/Professional Professional Modifier Low / Median / High Price $5,097.31 / $5,097.31 / $5,097.31	Professional		$5,097.31	$5,097.31	$5,097.31
United Facility/Professional Facility Modifier Low / Median / High Price $6,116.77 / $6,116.77 / $6,116.77	Facility		$6,116.77	$6,116.77	$6,116.77
United Facility/Professional Professional Modifier Low / Median / High Price $1,723.80 / $2,870.12 / $4,371.74	Professional		$1,723.80	$2,870.12	$4,371.74