Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $5,118.84 / $5,118.84 / $5,118.84	Facility		$5,118.84	$5,118.84	$5,118.84
Aetna Facility/Professional Professional Modifier Low / Median / High Price $4,106.08 / $5,118.84 / $8,499.20	Professional		$4,106.08	$5,118.84	$8,499.20
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $10,147.12 / $11,161.83 / $18,467.75	Facility		$10,147.12	$11,161.83	$18,467.75
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $8,776.24 / $9,436.82 / $12,480.95	Professional		$8,776.24	$9,436.82	$12,480.95
CareSource Facility/Professional Facility Modifier Low / Median / High Price $7,299.83 / $21,714.84 / $21,714.84	Facility		$7,299.83	$21,714.84	$21,714.84
Cigna Facility/Professional Facility Modifier Low / Median / High Price $7,957.05 / $20,978.29 / $42,355.01	Facility		$7,957.05	$20,978.29	$42,355.01
Cigna Facility/Professional Professional Modifier Low / Median / High Price $6,763.49 / $14,939.96 / $19,204.23	Professional		$6,763.49	$14,939.96	$19,204.23
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $2,883.76 / $7,678.26 / $11,669.19	Facility		$2,883.76	$7,678.26	$11,669.19
DeanCare Facility/Professional Professional Modifier Low / Median / High Price $5,810.00 / $10,147.12 / $12,176.54	Professional		$5,810.00	$10,147.12	$12,176.54
Medica Facility/Professional Facility Modifier Low / Median / High Price $4,991.89 / $10,147.12 / $43,045.38	Facility		$4,991.89	$10,147.12	$43,045.38
Medica Facility/Professional Professional Modifier Low / Median / High Price $4,570.80 / $6,728.77 / $11,048.97	Professional		$4,570.80	$6,728.77	$11,048.97
Molina Facility/Professional Professional Modifier Low / Median / High Price $50.00 / $70.00 / $6,000.00	Professional		$50.00	$70.00	$6,000.00
Prevea360 Facility/Professional Facility Modifier Low / Median / High Price $2,883.76 / $7,678.26 / $11,669.19	Facility		$2,883.76	$7,678.26	$11,669.19
Prevea360 Facility/Professional Professional Modifier Low / Median / High Price $5,810.00 / $10,147.12 / $12,176.54	Professional		$5,810.00	$10,147.12	$12,176.54
Quartz Facility/Professional Professional Modifier Low / Median / High Price $10,147.12 / $15,616.09 / $26,802.80	Professional		$10,147.12	$15,616.09	$26,802.80
Quartz Facility/Professional Facility Modifier Low / Median / High Price $7,957.05 / $19,818.59 / $43,045.38	Facility		$7,957.05	$19,818.59	$43,045.38
Quartz Facility/Professional Professional Modifier Low / Median / High Price $6,763.49 / $7,957.05 / $49,817.58	Professional		$6,763.49	$7,957.05	$49,817.58
Security Health Facility/Professional Professional Modifier Low / Median / High Price $10,147.12 / $10,147.12 / $10,147.12	Professional		$10,147.12	$10,147.12	$10,147.12
Security Health Facility/Professional Professional Modifier Low / Median / High Price $10,147.12 / $10,147.12 / $10,147.12	Professional		$10,147.12	$10,147.12	$10,147.12
United Facility/Professional Facility Modifier Low / Median / High Price $14,325.92 / $14,325.92 / $14,325.92	Facility		$14,325.92	$14,325.92	$14,325.92
United Facility/Professional Professional Modifier Low / Median / High Price $4,037.26 / $5,955.87 / $8,996.60	Professional		$4,037.26	$5,955.87	$8,996.60