Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $2,289.87 / $2,289.87 / $2,289.87	Facility		$2,289.87	$2,289.87	$2,289.87
Aetna Facility/Professional Professional Modifier Low / Median / High Price $1,853.77 / $2,289.87 / $3,802.05	Professional		$1,853.77	$2,289.87	$3,802.05
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $4,539.22 / $4,993.14 / $8,261.40	Facility		$4,539.22	$4,993.14	$8,261.40
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $4,085.30 / $4,221.47 / $5,583.25	Professional		$4,085.30	$4,221.47	$5,583.25
CareSource Facility/Professional Facility Modifier Low / Median / High Price $1,306.22 / $3,885.62 / $9,713.95	Facility		$1,306.22	$3,885.62	$9,713.95
Cigna Facility/Professional Facility Modifier Low / Median / High Price $3,600.52 / $9,384.54 / $18,947.30	Facility		$3,600.52	$9,384.54	$18,947.30
Cigna Facility/Professional Professional Modifier Low / Median / High Price $3,060.44 / $6,683.22 / $8,590.85	Professional		$3,060.44	$6,683.22	$8,590.85
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $1,304.88 / $3,434.81 / $5,220.10	Facility		$1,304.88	$3,434.81	$5,220.10
DeanCare Facility/Professional Professional Modifier Low / Median / High Price $2,599.05 / $4,539.22 / $5,447.08	Professional		$2,599.05	$4,539.22	$5,447.08
Medica Facility/Professional Facility Modifier Low / Median / High Price $2,258.80 / $4,539.22 / $21,186.55	Facility		$2,258.80	$4,539.22	$21,186.55
Medica Facility/Professional Professional Modifier Low / Median / High Price $2,044.70 / $3,032.98 / $4,942.66	Professional		$2,044.70	$3,032.98	$4,942.66
Molina Facility/Professional Professional Modifier Low / Median / High Price $50.00 / $85.00 / $2,893.39	Professional		$50.00	$85.00	$2,893.39
Prevea360 Facility/Professional Facility Modifier Low / Median / High Price $1,304.88 / $3,434.81 / $5,220.10	Facility		$1,304.88	$3,434.81	$5,220.10
Prevea360 Facility/Professional Professional Modifier Low / Median / High Price $2,599.05 / $4,539.22 / $5,447.08	Professional		$2,599.05	$4,539.22	$5,447.08
Quartz Facility/Professional Professional Modifier Low / Median / High Price $4,539.22 / $6,985.72 / $12,127.71	Professional		$4,539.22	$6,985.72	$12,127.71
Quartz Facility/Professional Facility Modifier Low / Median / High Price $3,600.52 / $8,865.68 / $21,186.55	Facility		$3,600.52	$8,865.68	$21,186.55
Quartz Facility/Professional Professional Modifier Low / Median / High Price $3,060.44 / $3,600.52 / $23,846.16	Professional		$3,060.44	$3,600.52	$23,846.16
Security Health Facility/Professional Professional Modifier Low / Median / High Price $4,539.22 / $4,539.22 / $4,539.22	Professional		$4,539.22	$4,539.22	$4,539.22
Security Health Facility/Professional Professional Modifier Low / Median / High Price $4,539.22 / $4,539.22 / $4,539.22	Professional		$4,539.22	$4,539.22	$4,539.22
United Facility/Professional Professional Modifier Low / Median / High Price $1,582.62 / $2,695.00 / $3,893.10	Professional		$1,582.62	$2,695.00	$3,893.10