Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $5,450.11 / $5,450.11 / $5,450.11	Facility		$5,450.11	$5,450.11	$5,450.11
Aetna Facility/Professional Professional Modifier Low / Median / High Price $4,491.89 / $5,450.11 / $9,064.26	Professional		$4,491.89	$5,450.11	$9,064.26
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $10,803.79 / $11,884.17 / $19,662.90	Facility		$10,803.79	$11,884.17	$19,662.90
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $10,047.52 / $10,047.52 / $13,288.66	Professional		$10,047.52	$10,047.52	$13,288.66
CareSource Facility/Professional Facility Modifier Low / Median / High Price $7,772.23 / $23,120.11 / $23,120.11	Facility		$7,772.23	$23,120.11	$23,120.11
Cigna Facility/Professional Facility Modifier Low / Median / High Price $7,261.93 / $22,335.70 / $45,095.35	Facility		$7,261.93	$22,335.70	$45,095.35
Cigna Facility/Professional Professional Modifier Low / Median / High Price $5,301.21 / $17,993.38 / $20,447.03	Professional		$5,301.21	$17,993.38	$20,447.03
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $2,978.39 / $8,175.17 / $12,424.36	Facility		$2,978.39	$8,175.17	$12,424.36
DeanCare Facility/Professional Professional Modifier Low / Median / High Price $6,185.98 / $10,212.86 / $12,964.55	Professional		$6,185.98	$10,212.86	$12,964.55
Medica Facility/Professional Facility Modifier Low / Median / High Price $5,155.71 / $10,803.79 / $48,028.87	Facility		$5,155.71	$10,803.79	$48,028.87
Medica Facility/Professional Professional Modifier Low / Median / High Price $4,866.59 / $6,949.58 / $11,764.00	Professional		$4,866.59	$6,949.58	$11,764.00
Molina Facility/Professional Professional Modifier Low / Median / High Price $50.00 / $70.00 / $6,792.66	Professional		$50.00	$70.00	$6,792.66
Prevea360 Facility/Professional Facility Modifier Low / Median / High Price $2,978.39 / $8,175.17 / $12,424.36	Facility		$2,978.39	$8,175.17	$12,424.36
Prevea360 Facility/Professional Professional Modifier Low / Median / High Price $6,185.98 / $10,212.86 / $12,964.55	Professional		$6,185.98	$10,212.86	$12,964.55
Quartz Facility/Professional Professional Modifier Low / Median / High Price $10,803.79 / $16,626.66 / $27,682.05	Professional		$10,803.79	$16,626.66	$27,682.05
Quartz Facility/Professional Facility Modifier Low / Median / High Price $7,261.93 / $21,101.16 / $48,028.87	Facility		$7,261.93	$21,101.16	$48,028.87
Quartz Facility/Professional Professional Modifier Low / Median / High Price $5,301.21 / $7,261.93 / $52,297.82	Professional		$5,301.21	$7,261.93	$52,297.82
Security Health Facility/Professional Professional Modifier Low / Median / High Price $10,803.79 / $10,803.79 / $10,803.79	Professional		$10,803.79	$10,803.79	$10,803.79
Security Health Facility/Professional Professional Modifier Low / Median / High Price $10,803.79 / $10,803.79 / $10,803.79	Professional		$10,803.79	$10,803.79	$10,803.79
United Facility/Professional Professional Modifier Low / Median / High Price $4,169.75 / $6,151.33 / $9,578.82	Professional		$4,169.75	$6,151.33	$9,578.82