Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $6,810.12 / $6,810.12 / $6,810.12	Facility		$6,810.12	$6,810.12	$6,810.12
Aetna Facility/Professional Professional Modifier Low / Median / High Price $4,621.43 / $6,810.12 / $11,307.38	Professional		$4,621.43	$6,810.12	$11,307.38
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $13,499.77 / $14,849.75 / $24,569.58	Facility		$13,499.77	$14,849.75	$24,569.58
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $11,675.95 / $12,554.79 / $16,604.71	Professional		$11,675.95	$12,554.79	$16,604.71
CareSource Facility/Professional Facility Modifier Low / Median / High Price $9,711.70 / $28,889.51 / $28,889.51	Facility		$9,711.70	$28,889.51	$28,889.51
Cigna Facility/Professional Facility Modifier Low / Median / High Price $8,732.85 / $27,909.79 / $56,349.25	Facility		$8,732.85	$27,909.79	$56,349.25
Cigna Facility/Professional Professional Modifier Low / Median / High Price $6,374.98 / $19,562.81 / $25,549.38	Professional		$6,374.98	$19,562.81	$25,549.38
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $3,573.07 / $10,215.18 / $15,524.74	Facility		$3,573.07	$10,215.18	$15,524.74
DeanCare Facility/Professional Professional Modifier Low / Median / High Price $7,729.65 / $11,093.94 / $16,199.72	Professional		$7,729.65	$11,093.94	$16,199.72
Medica Facility/Professional Facility Modifier Low / Median / High Price $6,185.12 / $13,499.77 / $58,756.37	Facility		$6,185.12	$13,499.77	$58,756.37
Medica Facility/Professional Professional Modifier Low / Median / High Price $6,081.01 / $8,337.16 / $14,699.59	Professional		$6,081.01	$8,337.16	$14,699.59
Molina Facility/Professional Professional Modifier Low / Median / High Price $50.00 / $70.00 / $6,989.33	Professional		$50.00	$70.00	$6,989.33
Prevea360 Facility/Professional Facility Modifier Low / Median / High Price $3,573.07 / $10,215.18 / $15,524.74	Facility		$3,573.07	$10,215.18	$15,524.74
Prevea360 Facility/Professional Professional Modifier Low / Median / High Price $7,729.65 / $11,093.94 / $16,199.72	Professional		$7,729.65	$11,093.94	$16,199.72
Quartz Facility/Professional Professional Modifier Low / Median / High Price $13,499.77 / $20,775.68 / $33,209.42	Professional		$13,499.77	$20,775.68	$33,209.42
Quartz Facility/Professional Facility Modifier Low / Median / High Price $8,732.85 / $26,366.74 / $58,756.37	Facility		$8,732.85	$26,366.74	$58,756.37
Quartz Facility/Professional Professional Modifier Low / Median / High Price $6,374.98 / $8,732.85 / $72,157.73	Professional		$6,374.98	$8,732.85	$72,157.73
Security Health Facility/Professional Professional Modifier Low / Median / High Price $13,499.77 / $13,499.77 / $13,499.77	Professional		$13,499.77	$13,499.77	$13,499.77
Security Health Facility/Professional Professional Modifier Low / Median / High Price $13,499.77 / $13,499.77 / $13,499.77	Professional		$13,499.77	$13,499.77	$13,499.77
United Facility/Professional Facility Modifier Low / Median / High Price $5,544.86 / $5,544.86 / $5,544.86	Facility		$5,544.86	$5,544.86	$5,544.86
United Facility/Professional Professional Modifier Low / Median / High Price $4,612.20 / $8,099.86 / $13,499.77	Professional		$4,612.20	$8,099.86	$13,499.77