Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $2,224.36 / $2,224.36 / $2,224.36	Facility		$2,224.36	$2,224.36	$2,224.36
Aetna Facility/Professional Professional Modifier Low / Median / High Price $1,720.49 / $2,224.36 / $3,693.27	Professional		$1,720.49	$2,224.36	$3,693.27
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $4,409.35 / $4,850.30 / $8,025.04	Facility		$4,409.35	$4,850.30	$8,025.04
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $3,813.65 / $4,100.70 / $5,423.51	Professional		$3,813.65	$4,100.70	$5,423.51
CareSource Facility/Professional Facility Modifier Low / Median / High Price $3,172.08 / $9,436.03 / $9,436.03	Facility		$3,172.08	$9,436.03	$9,436.03
Cigna Facility/Professional Facility Modifier Low / Median / High Price $3,148.57 / $9,735.83 / $18,405.66	Facility		$3,148.57	$9,735.83	$18,405.66
Cigna Facility/Professional Professional Modifier Low / Median / High Price $2,298.46 / $6,491.76 / $8,345.06	Professional		$2,298.46	$6,491.76	$8,345.06
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $1,330.20 / $3,336.54 / $5,070.76	Facility		$1,330.20	$3,336.54	$5,070.76
DeanCare Facility/Professional Professional Modifier Low / Median / High Price $2,524.69 / $4,130.10 / $5,291.23	Professional		$2,524.69	$4,130.10	$5,291.23
Medica Facility/Professional Facility Modifier Low / Median / High Price $2,224.36 / $4,409.35 / $20,548.93	Facility		$2,224.36	$4,409.35	$20,548.93
Medica Facility/Professional Professional Modifier Low / Median / High Price $2,050.15 / $3,072.89 / $4,801.25	Professional		$2,050.15	$3,072.89	$4,801.25
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 $1,330.20 / $3,336.54 / $5,070.76	Facility		$1,330.20	$3,336.54	$5,070.76
Prevea360 Facility/Professional Professional Modifier Low / Median / High Price $2,524.69 / $4,130.10 / $5,291.23	Professional		$2,524.69	$4,130.10	$5,291.23
Quartz Facility/Professional Professional Modifier Low / Median / High Price $4,409.35 / $6,785.87 / $12,363.58	Professional		$4,409.35	$6,785.87	$12,363.58
Quartz Facility/Professional Facility Modifier Low / Median / High Price $3,148.57 / $8,612.04 / $20,548.93	Facility		$3,148.57	$8,612.04	$20,548.93
Quartz Facility/Professional Professional Modifier Low / Median / High Price $2,298.46 / $3,148.57 / $27,258.76	Professional		$2,298.46	$3,148.57	$27,258.76
Security Health Facility/Professional Professional Modifier Low / Median / High Price $4,409.35 / $4,409.35 / $4,409.35	Professional		$4,409.35	$4,409.35	$4,409.35
Security Health Facility/Professional Professional Modifier Low / Median / High Price $3,520.75 / $4,409.35 / $4,409.35	Professional		$3,520.75	$4,409.35	$4,409.35
United Facility/Professional Professional Modifier Low / Median / High Price $1,756.63 / $2,747.29 / $4,801.25	Professional		$1,756.63	$2,747.29	$4,801.25