Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $1,819.63 / $1,819.63 / $1,819.63	Facility		$1,819.63	$1,819.63	$1,819.63
Aetna Facility/Professional Professional Modifier Low / Median / High Price $1,473.09 / $1,819.63 / $3,021.27	Professional		$1,473.09	$1,819.63	$3,021.27
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $3,607.06 / $3,967.77 / $6,564.85	Facility		$3,607.06	$3,967.77	$6,564.85
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $3,234.33 / $3,354.57 / $4,436.68	Professional		$3,234.33	$3,354.57	$4,436.68
CareSource Facility/Professional Facility Modifier Low / Median / High Price $1,037.97 / $3,087.70 / $7,719.11	Facility		$1,037.97	$3,087.70	$7,719.11
Cigna Facility/Professional Facility Modifier Low / Median / High Price $2,861.13 / $7,456.81 / $15,056.51	Facility		$2,861.13	$7,456.81	$15,056.51
Cigna Facility/Professional Professional Modifier Low / Median / High Price $2,431.96 / $5,310.66 / $6,826.65	Professional		$2,431.96	$5,310.66	$6,826.65
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $1,036.91 / $2,729.45 / $4,148.12	Facility		$1,036.91	$2,729.45	$4,148.12
DeanCare Facility/Professional Professional Modifier Low / Median / High Price $2,065.32 / $3,607.06 / $4,328.47	Professional		$2,065.32	$3,607.06	$4,328.47
Medica Facility/Professional Facility Modifier Low / Median / High Price $1,794.94 / $3,607.06 / $16,835.74	Facility		$1,794.94	$3,607.06	$16,835.74
Medica Facility/Professional Professional Modifier Low / Median / High Price $1,624.81 / $2,410.14 / $3,927.65	Professional		$1,624.81	$2,410.14	$3,927.65
Molina Facility/Professional Professional Modifier Low / Median / High Price $50.00 / $85.00 / $2,299.21	Professional		$50.00	$85.00	$2,299.21
Prevea360 Facility/Professional Facility Modifier Low / Median / High Price $1,036.91 / $2,729.45 / $4,148.12	Facility		$1,036.91	$2,729.45	$4,148.12
Prevea360 Facility/Professional Professional Modifier Low / Median / High Price $2,065.32 / $3,607.06 / $4,328.47	Professional		$2,065.32	$3,607.06	$4,328.47
Quartz Facility/Professional Professional Modifier Low / Median / High Price $3,607.06 / $5,551.12 / $9,637.53	Professional		$3,607.06	$5,551.12	$9,637.53
Quartz Facility/Professional Facility Modifier Low / Median / High Price $2,861.13 / $7,045.04 / $16,835.74	Facility		$2,861.13	$7,045.04	$16,835.74
Quartz Facility/Professional Professional Modifier Low / Median / High Price $2,431.96 / $2,861.13 / $18,949.15	Professional		$2,431.96	$2,861.13	$18,949.15
Security Health Facility/Professional Professional Modifier Low / Median / High Price $3,607.06 / $3,607.06 / $3,607.06	Professional		$3,607.06	$3,607.06	$3,607.06
Security Health Facility/Professional Professional Modifier Low / Median / High Price $3,607.06 / $3,607.06 / $3,607.06	Professional		$3,607.06	$3,607.06	$3,607.06
United Facility/Professional Professional Modifier Low / Median / High Price $1,437.01 / $2,164.23 / $3,093.61	Professional		$1,437.01	$2,164.23	$3,093.61