Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $2,044.52 / $2,044.52 / $2,044.52	Facility		$2,044.52	$2,044.52	$2,044.52
Aetna Facility/Professional Professional Modifier Low / Median / High Price $1,655.15 / $2,044.52 / $3,394.67	Professional		$1,655.15	$2,044.52	$3,394.67
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $4,052.87 / $4,458.16 / $7,376.22	Facility		$4,052.87	$4,458.16	$7,376.22
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $3,634.05 / $3,769.17 / $4,985.03	Professional		$3,634.05	$3,769.17	$4,985.03
CareSource Facility/Professional Facility Modifier Low / Median / High Price $1,166.26 / $3,469.30 / $8,673.14	Facility		$1,166.26	$3,469.30	$8,673.14
Cigna Facility/Professional Facility Modifier Low / Median / High Price $3,214.74 / $8,378.95 / $16,916.53	Facility		$3,214.74	$8,378.95	$16,916.53
Cigna Facility/Professional Professional Modifier Low / Median / High Price $2,732.53 / $5,966.94 / $7,670.38	Professional		$2,732.53	$5,966.94	$7,670.38
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $1,165.07 / $3,066.78 / $4,660.80	Facility		$1,165.07	$3,066.78	$4,660.80
DeanCare Facility/Professional Professional Modifier Low / Median / High Price $2,320.57 / $4,052.87 / $4,863.43	Professional		$2,320.57	$4,052.87	$4,863.43
Medica Facility/Professional Facility Modifier Low / Median / High Price $2,016.78 / $4,052.87 / $18,916.50	Facility		$2,016.78	$4,052.87	$18,916.50
Medica Facility/Professional Professional Modifier Low / Median / High Price $1,825.62 / $2,708.01 / $4,413.07	Professional		$1,825.62	$2,708.01	$4,413.07
Molina Facility/Professional Professional Modifier Low / Median / High Price $50.00 / $85.00 / $2,583.37	Professional		$50.00	$85.00	$2,583.37
Prevea360 Facility/Professional Facility Modifier Low / Median / High Price $1,165.07 / $3,066.78 / $4,660.80	Facility		$1,165.07	$3,066.78	$4,660.80
Prevea360 Facility/Professional Professional Modifier Low / Median / High Price $2,320.57 / $4,052.87 / $4,863.43	Professional		$2,320.57	$4,052.87	$4,863.43
Quartz Facility/Professional Professional Modifier Low / Median / High Price $4,052.87 / $6,237.23 / $10,828.92	Professional		$4,052.87	$6,237.23	$10,828.92
Quartz Facility/Professional Facility Modifier Low / Median / High Price $3,214.74 / $7,915.76 / $18,916.50	Facility		$3,214.74	$7,915.76	$18,916.50
Quartz Facility/Professional Professional Modifier Low / Median / High Price $2,732.53 / $3,214.74 / $21,291.26	Professional		$2,732.53	$3,214.74	$21,291.26
Security Health Facility/Professional Professional Modifier Low / Median / High Price $4,052.87 / $4,052.87 / $4,052.87	Professional		$4,052.87	$4,052.87	$4,052.87
Security Health Facility/Professional Professional Modifier Low / Median / High Price $4,052.87 / $4,052.87 / $4,052.87	Professional		$4,052.87	$4,052.87	$4,052.87
United Facility/Professional Professional Modifier Low / Median / High Price $1,614.61 / $2,406.23 / $3,593.34	Professional		$1,614.61	$2,406.23	$3,593.34