Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $5,218.24 / $5,218.24 / $5,218.24	Facility		$5,218.24	$5,218.24	$5,218.24
Aetna Facility/Professional Professional Modifier Low / Median / High Price $4,218.89 / $5,218.24 / $8,664.24	Professional		$4,218.89	$5,218.24	$8,664.24
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $10,344.16 / $11,378.58 / $18,826.37	Facility		$10,344.16	$11,378.58	$18,826.37
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $9,620.07 / $9,620.07 / $12,723.31	Professional		$9,620.07	$9,620.07	$12,723.31
CareSource Facility/Professional Facility Modifier Low / Median / High Price $7,441.56 / $22,136.50 / $22,136.50	Facility		$7,441.56	$22,136.50	$22,136.50
Cigna Facility/Professional Facility Modifier Low / Median / High Price $5,687.89 / $30,851.00 / $43,177.95	Facility		$5,687.89	$30,851.00	$43,177.95
Cigna Facility/Professional Professional Modifier Low / Median / High Price $4,834.71 / $14,990.16 / $19,577.14	Professional		$4,834.71	$14,990.16	$19,577.14
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $5,218.24 / $8,097.21 / $11,895.78	Facility		$5,218.24	$8,097.21	$11,895.78
DeanCare Facility/Professional Professional Modifier Low / Median / High Price $10,323.46 / $10,344.16 / $12,412.99	Professional		$10,323.46	$10,344.16	$12,412.99
Medica Facility/Professional Facility Modifier Low / Median / High Price $6,667.01 / $10,344.16 / $44,565.35	Facility		$6,667.01	$10,344.16	$44,565.35
Medica Facility/Professional Professional Modifier Low / Median / High Price $4,857.64 / $6,880.78 / $11,353.07	Professional		$4,857.64	$6,880.78	$11,353.07
Molina Facility/Professional Professional Modifier Low / Median / High Price $50.00 / $58.40 / $70.00	Professional		$50.00	$58.40	$70.00
Prevea360 Facility/Professional Facility Modifier Low / Median / High Price $5,218.24 / $8,275.33 / $11,895.78	Facility		$5,218.24	$8,275.33	$11,895.78
Prevea360 Facility/Professional Professional Modifier Low / Median / High Price $10,323.46 / $10,344.16 / $12,412.99	Professional		$10,323.46	$10,344.16	$12,412.99
Quartz Facility/Professional Professional Modifier Low / Median / High Price $10,344.16 / $15,919.31 / $27,248.45	Professional		$10,344.16	$15,919.31	$27,248.45
Quartz Facility/Professional Facility Modifier Low / Median / High Price $5,687.89 / $20,203.43 / $44,565.35	Facility		$5,687.89	$20,203.43	$44,565.35
Quartz Facility/Professional Professional Modifier Low / Median / High Price $4,834.71 / $5,687.89 / $51,366.71	Professional		$4,834.71	$5,687.89	$51,366.71
Security Health Facility/Professional Professional Modifier Low / Median / High Price $10,344.16 / $10,344.16 / $10,344.16	Professional		$10,344.16	$10,344.16	$10,344.16
Security Health Facility/Professional Professional Modifier Low / Median / High Price $10,344.16 / $10,344.16 / $10,344.16	Professional		$10,344.16	$10,344.16	$10,344.16
United Facility/Professional Professional Modifier Low / Median / High Price $3,784.36 / $6,593.56 / $8,871.73	Professional		$3,784.36	$6,593.56	$8,871.73