Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $1,168.88 / $1,168.88 / $1,168.88	Facility		$1,168.88	$1,168.88	$1,168.88
Aetna Facility/Professional Professional Modifier Low / Median / High Price $887.71 / $1,168.88 / $1,940.79	Professional		$887.71	$1,168.88	$1,940.79
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $2,317.09 / $2,548.80 / $4,217.10	Facility		$2,317.09	$2,548.80	$4,217.10
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $2,004.04 / $2,154.89 / $2,850.02	Professional		$2,004.04	$2,154.89	$2,850.02
CareSource Facility/Professional Facility Modifier Low / Median / High Price $1,666.91 / $4,958.57 / $4,958.57	Facility		$1,666.91	$4,958.57	$4,958.57
Cigna Facility/Professional Facility Modifier Low / Median / High Price $1,498.90 / $4,790.78 / $9,672.39	Facility		$1,498.90	$4,790.78	$9,672.39
Cigna Facility/Professional Professional Modifier Low / Median / High Price $1,094.20 / $3,357.66 / $4,385.26	Professional		$1,094.20	$3,357.66	$4,385.26
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $567.55 / $1,753.32 / $2,664.65	Facility		$567.55	$1,753.32	$2,664.65
DeanCare Facility/Professional Professional Modifier Low / Median / High Price $1,326.71 / $2,317.09 / $2,780.51	Professional		$1,326.71	$2,317.09	$2,780.51
Medica Facility/Professional Facility Modifier Low / Median / High Price $982.47 / $2,317.09 / $9,517.39	Facility		$982.47	$2,317.09	$9,517.39
Medica Facility/Professional Professional Modifier Low / Median / High Price $939.43 / $1,324.60 / $2,523.02	Professional		$939.43	$1,324.60	$2,523.02
Molina Facility/Professional Professional Modifier Low / Median / High Price $50.00 / $70.00 / $883.64	Professional		$50.00	$70.00	$883.64
Prevea360 Facility/Professional Facility Modifier Low / Median / High Price $567.55 / $1,753.32 / $2,664.65	Facility		$567.55	$1,753.32	$2,664.65
Prevea360 Facility/Professional Professional Modifier Low / Median / High Price $1,326.71 / $2,317.09 / $2,780.51	Professional		$1,326.71	$2,317.09	$2,780.51
Quartz Facility/Professional Professional Modifier Low / Median / High Price $2,317.09 / $3,475.64 / $5,275.45	Professional		$2,317.09	$3,475.64	$5,275.45
Quartz Facility/Professional Facility Modifier Low / Median / High Price $1,498.90 / $4,525.56 / $9,517.39	Facility		$1,498.90	$4,525.56	$9,517.39
Quartz Facility/Professional Professional Modifier Low / Median / High Price $1,094.20 / $1,498.90 / $11,630.57	Professional		$1,094.20	$1,498.90	$11,630.57
Security Health Facility/Professional Professional Modifier Low / Median / High Price $2,317.09 / $2,317.09 / $2,317.09	Professional		$2,317.09	$2,317.09	$2,317.09
Security Health Facility/Professional Professional Modifier Low / Median / High Price $2,317.09 / $2,317.09 / $2,317.09	Professional		$2,317.09	$2,317.09	$2,317.09
United Facility/Professional Professional Modifier Low / Median / High Price $770.65 / $1,172.19 / $2,054.37	Professional		$770.65	$1,172.19	$2,054.37