Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $3,663.22 / $3,663.22 / $3,663.22	Facility		$3,663.22	$3,663.22	$3,663.22
Aetna Facility/Professional Professional Modifier Low / Median / High Price $3,594.10 / $3,721.01 / $7,508.69	Professional		$3,594.10	$3,721.01	$7,508.69
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $7,261.64 / $7,987.80 / $13,216.18	Facility		$7,261.64	$7,987.80	$13,216.18
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $6,280.59 / $6,753.33 / $8,931.81	Professional		$6,280.59	$6,753.33	$8,931.81
CareSource Facility/Professional Facility Modifier Low / Median / High Price $5,224.01 / $15,539.91 / $15,539.91	Facility		$5,224.01	$15,539.91	$15,539.91
Cigna Facility/Professional Facility Modifier Low / Median / High Price $4,697.47 / $15,013.05 / $30,310.36	Facility		$4,697.47	$15,013.05	$30,310.36
Cigna Facility/Professional Professional Modifier Low / Median / High Price $3,429.16 / $12,094.04 / $13,743.23	Professional		$3,429.16	$12,094.04	$13,743.23
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $2,266.64 / $5,494.83 / $8,350.89	Facility		$2,266.64	$5,494.83	$8,350.89
DeanCare Facility/Professional Professional Modifier Low / Median / High Price $4,157.84 / $7,037.63 / $8,713.96	Professional		$4,157.84	$7,037.63	$8,713.96
Medica Facility/Professional Facility Modifier Low / Median / High Price $3,663.22 / $7,261.64 / $35,737.98	Facility		$3,663.22	$7,261.64	$35,737.98
Medica Facility/Professional Professional Modifier Low / Median / High Price $3,376.33 / $4,852.02 / $7,907.03	Professional		$3,376.33	$4,852.02	$7,907.03
Molina Facility/Professional Professional Modifier Low / Median / High Price $50.00 / $70.00 / $4,193.60	Professional		$50.00	$70.00	$4,193.60
Prevea360 Facility/Professional Facility Modifier Low / Median / High Price $2,266.64 / $5,494.83 / $8,350.89	Facility		$2,266.64	$5,494.83	$8,350.89
Prevea360 Facility/Professional Professional Modifier Low / Median / High Price $4,157.84 / $7,037.63 / $8,713.96	Professional		$4,157.84	$7,037.63	$8,713.96
Quartz Facility/Professional Professional Modifier Low / Median / High Price $7,261.64 / $11,175.42 / $21,066.66	Professional		$7,261.64	$11,175.42	$21,066.66
Quartz Facility/Professional Facility Modifier Low / Median / High Price $4,697.47 / $14,182.90 / $35,737.98	Facility		$4,697.47	$14,182.90	$35,737.98
Quartz Facility/Professional Professional Modifier Low / Median / High Price $3,429.16 / $4,697.47 / $46,448.37	Professional		$3,429.16	$4,697.47	$46,448.37
Security Health Facility/Professional Professional Modifier Low / Median / High Price $7,261.64 / $7,261.64 / $7,261.64	Professional		$7,261.64	$7,261.64	$7,261.64
Security Health Facility/Professional Professional Modifier Low / Median / High Price $7,261.64 / $7,261.64 / $7,261.64	Professional		$7,261.64	$7,261.64	$7,261.64
United Facility/Professional Professional Modifier Low / Median / High Price $2,749.08 / $4,628.70 / $6,438.29	Professional		$2,749.08	$4,628.70	$6,438.29