Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $3,967.87 / $3,967.87 / $3,967.87	Facility		$3,967.87	$3,967.87	$3,967.87
Aetna Facility/Professional Professional Modifier Low / Median / High Price $3,294.32 / $3,967.87 / $6,647.67	Professional		$3,294.32	$3,967.87	$6,647.67
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $7,865.54 / $8,652.09 / $14,315.28	Facility		$7,865.54	$8,652.09	$14,315.28
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $7,078.98 / $7,314.95 / $9,674.61	Professional		$7,078.98	$7,314.95	$9,674.61
CareSource Facility/Professional Facility Modifier Low / Median / High Price $5,658.45 / $16,832.25 / $16,832.25	Facility		$5,658.45	$16,832.25	$16,832.25
Cigna Facility/Professional Facility Modifier Low / Median / High Price $4,391.66 / $23,458.00 / $32,830.97	Facility		$4,391.66	$23,458.00	$32,830.97
Cigna Facility/Professional Professional Modifier Low / Median / High Price $3,732.91 / $11,580.50 / $14,886.15	Professional		$3,732.91	$11,580.50	$14,886.15
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $2,263.62 / $5,951.81 / $9,045.37	Facility		$2,263.62	$5,951.81	$9,045.37
DeanCare Facility/Professional Professional Modifier Low / Median / High Price $4,503.62 / $7,677.00 / $9,438.65	Professional		$4,503.62	$7,677.00	$9,438.65
Medica Facility/Professional Facility Modifier Low / Median / High Price $3,918.41 / $7,865.54 / $33,788.62	Facility		$3,918.41	$7,865.54	$33,788.62
Medica Facility/Professional Professional Modifier Low / Median / High Price $3,592.50 / $5,255.53 / $8,564.60	Professional		$3,592.50	$5,255.53	$8,564.60
Molina Facility/Professional Professional Modifier Low / Median / High Price $50.00 / $65.00 / $85.00	Professional		$50.00	$65.00	$85.00
Prevea360 Facility/Professional Facility Modifier Low / Median / High Price $2,263.62 / $5,951.81 / $9,045.37	Facility		$2,263.62	$5,951.81	$9,045.37
Prevea360 Facility/Professional Professional Modifier Low / Median / High Price $4,503.62 / $7,677.00 / $9,438.65	Professional		$4,503.62	$7,677.00	$9,438.65
Quartz Facility/Professional Professional Modifier Low / Median / High Price $7,865.54 / $12,104.80 / $21,038.56	Professional		$7,865.54	$12,104.80	$21,038.56
Quartz Facility/Professional Facility Modifier Low / Median / High Price $4,391.66 / $15,362.38 / $33,788.62	Facility		$4,391.66	$15,362.38	$33,788.62
Quartz Facility/Professional Professional Modifier Low / Median / High Price $3,732.91 / $4,391.66 / $39,678.90	Professional		$3,732.91	$4,391.66	$39,678.90
Security Health Facility/Professional Professional Modifier Low / Median / High Price $7,865.54 / $7,865.54 / $7,865.54	Professional		$7,865.54	$7,865.54	$7,865.54
Security Health Facility/Professional Professional Modifier Low / Median / High Price $7,865.54 / $7,865.54 / $7,865.54	Professional		$7,865.54	$7,865.54	$7,865.54
United Facility/Professional Professional Modifier Low / Median / High Price $2,921.93 / $5,013.63 / $6,745.92	Professional		$2,921.93	$5,013.63	$6,745.92