Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $1,181.03 / $1,181.03 / $1,181.03	Facility		$1,181.03	$1,181.03	$1,181.03
Aetna Facility/Professional Professional Modifier Low / Median / High Price $892.78 / $1,181.03 / $1,960.95	Professional		$892.78	$1,181.03	$1,960.95
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $2,341.16 / $2,575.28 / $4,260.91	Facility		$2,341.16	$2,575.28	$4,260.91
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $2,024.87 / $2,177.28 / $2,879.62	Professional		$2,024.87	$2,177.28	$2,879.62
CareSource Facility/Professional Facility Modifier Low / Median / High Price $1,684.23 / $5,010.08 / $5,010.08	Facility		$1,684.23	$5,010.08	$5,010.08
Cigna Facility/Professional Facility Modifier Low / Median / High Price $1,132.82 / $4,840.50 / $9,771.76	Facility		$1,132.82	$4,840.50	$9,771.76
Cigna Facility/Professional Professional Modifier Low / Median / High Price $826.96 / $3,899.13 / $4,430.83	Professional		$826.96	$3,899.13	$4,430.83
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $583.89 / $1,771.55 / $2,692.33	Facility		$583.89	$1,771.55	$2,692.33
DeanCare Facility/Professional Professional Modifier Low / Median / High Price $1,340.49 / $2,341.16 / $2,809.39	Professional		$1,340.49	$2,341.16	$2,809.39
Medica Facility/Professional Facility Modifier Low / Median / High Price $1,010.74 / $2,341.16 / $9,810.68	Facility		$1,010.74	$2,341.16	$9,810.68
Medica Facility/Professional Professional Modifier Low / Median / High Price $1,054.58 / $1,362.73 / $2,549.23	Professional		$1,054.58	$1,362.73	$2,549.23
Molina Facility/Professional Professional Modifier Low / Median / High Price $50.00 / $70.00 / $847.77	Professional		$50.00	$70.00	$847.77
Prevea360 Facility/Professional Facility Modifier Low / Median / High Price $583.89 / $1,771.55 / $2,692.33	Facility		$583.89	$1,771.55	$2,692.33
Prevea360 Facility/Professional Professional Modifier Low / Median / High Price $1,340.49 / $2,341.16 / $2,809.39	Professional		$1,340.49	$2,341.16	$2,809.39
Quartz Facility/Professional Professional Modifier Low / Median / High Price $2,341.16 / $3,511.74 / $5,427.01	Professional		$2,341.16	$3,511.74	$5,427.01
Quartz Facility/Professional Facility Modifier Low / Median / High Price $1,132.82 / $4,572.58 / $9,810.68	Facility		$1,132.82	$4,572.58	$9,810.68
Quartz Facility/Professional Professional Modifier Low / Median / High Price $826.96 / $1,132.82 / $11,557.54	Professional		$826.96	$1,132.82	$11,557.54
Security Health Facility/Professional Professional Modifier Low / Median / High Price $2,341.16 / $2,341.16 / $2,341.16	Professional		$2,341.16	$2,341.16	$2,341.16
Security Health Facility/Professional Professional Modifier Low / Median / High Price $2,341.16 / $2,341.16 / $2,341.16	Professional		$2,341.16	$2,341.16	$2,341.16
United Facility/Professional Facility Modifier Low / Median / High Price $1,052.80 / $1,052.80 / $1,052.80	Facility		$1,052.80	$1,052.80	$1,052.80
United Facility/Professional Professional Modifier Low / Median / High Price $817.45 / $1,361.06 / $2,261.12	Professional		$817.45	$1,361.06	$2,261.12