Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $1,852.34 / $1,852.34 / $1,852.34	Facility		$1,852.34	$1,852.34	$1,852.34
Aetna Facility/Professional Professional Modifier Low / Median / High Price $1,409.56 / $1,852.34 / $3,075.58	Professional		$1,409.56	$1,852.34	$3,075.58
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $3,671.91 / $4,039.10 / $6,682.88	Facility		$3,671.91	$4,039.10	$6,682.88
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $3,175.83 / $3,414.88 / $4,516.43	Professional		$3,175.83	$3,414.88	$4,516.43
CareSource Facility/Professional Facility Modifier Low / Median / High Price $2,641.56 / $7,857.89 / $7,857.89	Facility		$2,641.56	$7,857.89	$7,857.89
Cigna Facility/Professional Facility Modifier Low / Median / High Price $2,375.33 / $7,590.96 / $15,326.63	Facility		$2,375.33	$7,590.96	$15,326.63
Cigna Facility/Professional Professional Modifier Low / Median / High Price $1,733.99 / $5,321.25 / $6,949.38	Professional		$1,733.99	$5,321.25	$6,949.38
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $1,089.80 / $2,778.51 / $4,222.70	Facility		$1,089.80	$2,778.51	$4,222.70
DeanCare Facility/Professional Professional Modifier Low / Median / High Price $2,102.46 / $3,383.69 / $4,406.29	Professional		$2,102.46	$3,383.69	$4,406.29
Medica Facility/Professional Facility Modifier Low / Median / High Price $1,852.34 / $3,671.91 / $16,837.56	Facility		$1,852.34	$3,671.91	$16,837.56
Medica Facility/Professional Professional Modifier Low / Median / High Price $1,688.09 / $2,453.48 / $3,998.26	Professional		$1,688.09	$2,453.48	$3,998.26
Molina Facility/Professional Professional Modifier Low / Median / High Price $50.00 / $70.00 / $2,478.01	Professional		$50.00	$70.00	$2,478.01
Prevea360 Facility/Professional Facility Modifier Low / Median / High Price $1,089.80 / $2,778.51 / $4,222.70	Facility		$1,089.80	$2,778.51	$4,222.70
Prevea360 Facility/Professional Professional Modifier Low / Median / High Price $2,102.46 / $3,383.69 / $4,406.29	Professional		$2,102.46	$3,383.69	$4,406.29
Quartz Facility/Professional Professional Modifier Low / Median / High Price $3,671.91 / $5,650.95 / $10,129.34	Professional		$3,671.91	$5,650.95	$10,129.34
Quartz Facility/Professional Facility Modifier Low / Median / High Price $2,375.33 / $7,171.70 / $16,837.56	Facility		$2,375.33	$7,171.70	$16,837.56
Quartz Facility/Professional Professional Modifier Low / Median / High Price $1,733.99 / $2,375.33 / $22,332.37	Professional		$1,733.99	$2,375.33	$22,332.37
Security Health Facility/Professional Professional Modifier Low / Median / High Price $3,671.91 / $3,671.91 / $3,671.91	Professional		$3,671.91	$3,671.91	$3,671.91
Security Health Facility/Professional Professional Modifier Low / Median / High Price $3,671.91 / $3,671.91 / $3,671.91	Professional		$3,671.91	$3,671.91	$3,671.91
United Facility/Professional Facility Modifier Low / Median / High Price $5,413.91 / $5,413.91 / $5,413.91	Facility		$5,413.91	$5,413.91	$5,413.91
United Facility/Professional Professional Modifier Low / Median / High Price $1,406.74 / $2,250.78 / $3,998.26	Professional		$1,406.74	$2,250.78	$3,998.26