Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $3,449.31 / $3,449.31 / $3,449.31	Facility		$3,449.31	$3,449.31	$3,449.31
Aetna Facility/Professional Professional Modifier Low / Median / High Price $2,707.87 / $3,449.31 / $5,727.15	Professional		$2,707.87	$3,449.31	$5,727.15
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $6,837.60 / $7,521.36 / $12,444.43	Facility		$6,837.60	$7,521.36	$12,444.43
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $6,153.84 / $6,358.97 / $8,410.24	Professional		$6,153.84	$6,358.97	$8,410.24
CareSource Facility/Professional Facility Modifier Low / Median / High Price $4,918.96 / $14,632.46 / $14,632.46	Facility		$4,918.96	$14,632.46	$14,632.46
Cigna Facility/Professional Facility Modifier Low / Median / High Price $4,423.18 / $15,096.63 / $28,541.31	Facility		$4,423.18	$15,096.63	$28,541.31
Cigna Facility/Professional Professional Modifier Low / Median / High Price $3,228.92 / $10,066.96 / $12,940.69	Professional		$3,228.92	$10,066.96	$12,940.69
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $2,093.60 / $5,173.97 / $7,863.24	Facility		$2,093.60	$5,173.97	$7,863.24
DeanCare Facility/Professional Professional Modifier Low / Median / High Price $3,915.06 / $6,837.60 / $8,205.12	Professional		$3,915.06	$6,837.60	$8,205.12
Medica Facility/Professional Facility Modifier Low / Median / High Price $3,449.31 / $6,837.60 / $33,517.87	Facility		$3,449.31	$6,837.60	$33,517.87
Medica Facility/Professional Professional Modifier Low / Median / High Price $3,179.17 / $4,765.16 / $7,445.30	Professional		$3,179.17	$4,765.16	$7,445.30
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 $2,093.60 / $5,173.97 / $7,863.24	Facility		$2,093.60	$5,173.97	$7,863.24
Prevea360 Facility/Professional Professional Modifier Low / Median / High Price $3,915.06 / $6,837.60 / $8,205.12	Professional		$3,915.06	$6,837.60	$8,205.12
Quartz Facility/Professional Professional Modifier Low / Median / High Price $6,837.60 / $10,522.84 / $19,458.73	Professional		$6,837.60	$10,522.84	$19,458.73
Quartz Facility/Professional Facility Modifier Low / Median / High Price $4,423.18 / $13,354.68 / $33,517.87	Facility		$4,423.18	$13,354.68	$33,517.87
Quartz Facility/Professional Professional Modifier Low / Median / High Price $3,228.92 / $4,423.18 / $42,902.39	Professional		$3,228.92	$4,423.18	$42,902.39
Security Health Facility/Professional Professional Modifier Low / Median / High Price $6,837.60 / $6,837.60 / $6,837.60	Professional		$6,837.60	$6,837.60	$6,837.60
Security Health Facility/Professional Professional Modifier Low / Median / High Price $5,459.67 / $6,837.60 / $6,837.60	Professional		$5,459.67	$6,837.60	$6,837.60
United Facility/Professional Professional Modifier Low / Median / High Price $2,539.19 / $4,102.56 / $5,864.31	Professional		$2,539.19	$4,102.56	$5,864.31