Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $1,149.08 / $1,149.08 / $1,149.08	Facility		$1,149.08	$1,149.08	$1,149.08
Aetna Facility/Professional Professional Modifier Low / Median / High Price $759.08 / $1,149.08 / $1,907.93	Professional		$759.08	$1,149.08	$1,907.93
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $2,277.86 / $2,505.65 / $4,145.71	Facility		$2,277.86	$2,505.65	$4,145.71
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $1,906.56 / $2,118.41 / $2,801.76	Professional		$1,906.56	$2,118.41	$2,801.76
CareSource Facility/Professional Facility Modifier Low / Median / High Price $1,638.68 / $4,874.62 / $4,874.62	Facility		$1,638.68	$4,874.62	$4,874.62
Cigna Facility/Professional Facility Modifier Low / Median / High Price $1,473.53 / $4,709.17 / $9,508.64	Facility		$1,473.53	$4,709.17	$9,508.64
Cigna Facility/Professional Professional Modifier Low / Median / High Price $1,075.68 / $3,300.94 / $4,311.03	Professional		$1,075.68	$3,300.94	$4,311.03
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $552.91 / $1,723.64 / $2,619.54	Facility		$552.91	$1,723.64	$2,619.54
DeanCare Facility/Professional Professional Modifier Low / Median / High Price $1,304.25 / $2,277.86 / $2,733.43	Professional		$1,304.25	$2,277.86	$2,733.43
Medica Facility/Professional Facility Modifier Low / Median / High Price $957.13 / $2,277.86 / $9,391.64	Facility		$957.13	$2,277.86	$9,391.64
Medica Facility/Professional Professional Modifier Low / Median / High Price $1,026.07 / $1,290.43 / $2,480.31	Professional		$1,026.07	$1,290.43	$2,480.31
Molina Facility/Professional Professional Modifier Low / Median / High Price $50.00 / $70.00 / $801.38	Professional		$50.00	$70.00	$801.38
Prevea360 Facility/Professional Facility Modifier Low / Median / High Price $552.91 / $1,723.64 / $2,619.54	Facility		$552.91	$1,723.64	$2,619.54
Prevea360 Facility/Professional Professional Modifier Low / Median / High Price $1,304.25 / $2,277.86 / $2,733.43	Professional		$1,304.25	$2,277.86	$2,733.43
Quartz Facility/Professional Professional Modifier Low / Median / High Price $2,277.86 / $3,416.79 / $5,138.93	Professional		$2,277.86	$3,416.79	$5,138.93
Quartz Facility/Professional Facility Modifier Low / Median / High Price $1,473.53 / $4,448.93 / $9,391.64	Facility		$1,473.53	$4,448.93	$9,391.64
Quartz Facility/Professional Professional Modifier Low / Median / High Price $1,075.68 / $1,473.53 / $10,987.20	Professional		$1,075.68	$1,473.53	$10,987.20
Security Health Facility/Professional Professional Modifier Low / Median / High Price $2,277.86 / $2,277.86 / $2,277.86	Professional		$2,277.86	$2,277.86	$2,277.86
Security Health Facility/Professional Professional Modifier Low / Median / High Price $2,277.86 / $2,277.86 / $2,277.86	Professional		$2,277.86	$2,277.86	$2,277.86
United Facility/Professional Professional Modifier Low / Median / High Price $774.09 / $1,228.71 / $2,205.30	Professional		$774.09	$1,228.71	$2,205.30