Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $4,344.76 / $4,344.76 / $4,344.76	Facility		$4,344.76	$4,344.76	$4,344.76
Aetna Facility/Professional Professional Modifier Low / Median / High Price $3,480.60 / $4,344.76 / $7,213.94	Professional		$3,480.60	$4,344.76	$7,213.94
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $8,612.66 / $9,473.93 / $15,675.04	Facility		$8,612.66	$9,473.93	$15,675.04
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $7,449.08 / $8,009.77 / $10,593.57	Professional		$7,449.08	$8,009.77	$10,593.57
CareSource Facility/Professional Facility Modifier Low / Median / High Price $6,195.93 / $18,431.09 / $18,431.09	Facility		$6,195.93	$18,431.09	$18,431.09
Cigna Facility/Professional Facility Modifier Low / Median / High Price $4,751.45 / $19,015.81 / $35,950.60	Facility		$4,751.45	$19,015.81	$35,950.60
Cigna Facility/Professional Professional Modifier Low / Median / High Price $4,038.73 / $12,480.94 / $16,300.13	Professional		$4,038.73	$12,480.94	$16,300.13
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $2,571.52 / $6,890.13 / $9,904.56	Facility		$2,571.52	$6,890.13	$9,904.56
DeanCare Facility/Professional Professional Modifier Low / Median / High Price $8,612.66 / $8,633.20 / $10,335.19	Professional		$8,612.66	$8,633.20	$10,335.19
Medica Facility/Professional Facility Modifier Low / Median / High Price $4,344.76 / $8,612.66 / $39,447.21	Facility		$4,344.76	$8,612.66	$39,447.21
Medica Facility/Professional Professional Modifier Low / Median / High Price $3,879.60 / $5,714.49 / $9,378.29	Professional		$3,879.60	$5,714.49	$9,378.29
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 $2,571.52 / $6,890.13 / $9,904.56	Facility		$2,571.52	$6,890.13	$9,904.56
Prevea360 Facility/Professional Professional Modifier Low / Median / High Price $8,612.66 / $8,633.20 / $10,335.19	Professional		$8,612.66	$8,633.20	$10,335.19
Quartz Facility/Professional Professional Modifier Low / Median / High Price $8,612.66 / $13,254.61 / $22,761.91	Professional		$8,612.66	$13,254.61	$22,761.91
Quartz Facility/Professional Facility Modifier Low / Median / High Price $4,751.45 / $16,821.59 / $39,447.21	Facility		$4,751.45	$16,821.59	$39,447.21
Quartz Facility/Professional Professional Modifier Low / Median / High Price $4,038.73 / $4,751.45 / $42,201.91	Professional		$4,038.73	$4,751.45	$42,201.91
Security Health Facility/Professional Professional Modifier Low / Median / High Price $8,612.66 / $8,612.66 / $8,612.66	Professional		$8,612.66	$8,612.66	$8,612.66
Security Health Facility/Professional Professional Modifier Low / Median / High Price $8,612.66 / $8,612.66 / $8,612.66	Professional		$8,612.66	$8,612.66	$8,612.66
United Facility/Professional Professional Modifier Low / Median / High Price $3,428.69 / $5,058.10 / $8,612.66	Professional		$3,428.69	$5,058.10	$8,612.66