Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $1,985.24 / $1,985.24 / $1,985.24	Facility		$1,985.24	$1,985.24	$1,985.24
Aetna Facility/Professional Professional Modifier Low / Median / High Price $1,285.26 / $1,985.24 / $3,296.24	Professional		$1,285.26	$1,985.24	$3,296.24
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $3,935.35 / $4,328.89 / $7,162.34	Facility		$3,935.35	$4,328.89	$7,162.34
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $3,541.81 / $3,659.88 / $4,840.47	Professional		$3,541.81	$3,659.88	$4,840.47
CareSource Facility/Professional Facility Modifier Low / Median / High Price $1,132.43 / $3,368.66 / $8,421.65	Facility		$1,132.43	$3,368.66	$8,421.65
Cigna Facility/Professional Facility Modifier Low / Median / High Price $2,253.75 / $8,135.96 / $16,426.68	Facility		$2,253.75	$8,135.96	$16,426.68
Cigna Facility/Professional Professional Modifier Low / Median / High Price $1,915.69 / $5,794.06 / $7,447.96	Professional		$1,915.69	$5,794.06	$7,447.96
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $950.61 / $2,977.86 / $4,525.64	Facility		$950.61	$2,977.86	$4,525.64
DeanCare Facility/Professional Professional Modifier Low / Median / High Price $2,253.29 / $3,257.91 / $4,722.42	Professional		$2,253.29	$3,257.91	$4,722.42
Medica Facility/Professional Facility Modifier Low / Median / High Price $1,645.54 / $3,935.35 / $15,333.41	Facility		$1,645.54	$3,935.35	$15,333.41
Medica Facility/Professional Professional Modifier Low / Median / High Price $1,567.79 / $2,218.57 / $4,285.12	Professional		$1,567.79	$2,218.57	$4,285.12
Molina Facility/Professional Professional Modifier Low / Median / High Price $50.00 / $85.00 / $3,135.58	Professional		$50.00	$85.00	$3,135.58
Prevea360 Facility/Professional Facility Modifier Low / Median / High Price $950.61 / $2,977.86 / $4,525.64	Facility		$950.61	$2,977.86	$4,525.64
Prevea360 Facility/Professional Professional Modifier Low / Median / High Price $2,253.29 / $3,257.91 / $4,722.42	Professional		$2,253.29	$3,257.91	$4,722.42
Quartz Facility/Professional Professional Modifier Low / Median / High Price $3,935.35 / $5,903.03 / $8,835.57	Professional		$3,935.35	$5,903.03	$8,835.57
Quartz Facility/Professional Facility Modifier Low / Median / High Price $2,253.75 / $7,686.24 / $15,333.41	Facility		$2,253.75	$7,686.24	$15,333.41
Quartz Facility/Professional Professional Modifier Low / Median / High Price $1,915.69 / $2,253.75 / $17,294.04	Professional		$1,915.69	$2,253.75	$17,294.04
Security Health Facility/Professional Professional Modifier Low / Median / High Price $3,935.35 / $3,935.35 / $3,935.35	Professional		$3,935.35	$3,935.35	$3,935.35
Security Health Facility/Professional Professional Modifier Low / Median / High Price $3,935.35 / $3,935.35 / $3,935.35	Professional		$3,935.35	$3,935.35	$3,935.35
United Facility/Professional Professional Modifier Low / Median / High Price $1,308.86 / $2,061.46 / $3,489.15	Professional		$1,308.86	$2,061.46	$3,489.15