Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $3,728.32 / $3,728.32 / $3,728.32	Facility		$3,728.32	$3,728.32	$3,728.32
Aetna Facility/Professional Professional Modifier Low / Median / High Price $3,014.32 / $3,728.32 / $6,190.41	Professional		$3,014.32	$3,728.32	$6,190.41
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $7,390.68 / $8,129.75 / $13,451.04	Facility		$7,390.68	$8,129.75	$13,451.04
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $6,873.33 / $6,873.33 / $9,090.53	Professional		$6,873.33	$6,873.33	$9,090.53
CareSource Facility/Professional Facility Modifier Low / Median / High Price $5,316.84 / $15,816.06 / $15,816.06	Facility		$5,316.84	$15,816.06	$15,816.06
Cigna Facility/Professional Facility Modifier Low / Median / High Price $4,063.89 / $22,042.00 / $30,849.19	Facility		$4,063.89	$22,042.00	$30,849.19
Cigna Facility/Professional Professional Modifier Low / Median / High Price $3,454.31 / $10,881.36 / $13,987.44	Professional		$3,454.31	$10,881.36	$13,987.44
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $2,094.67 / $5,592.48 / $8,499.28	Facility		$2,094.67	$5,592.48	$8,499.28
DeanCare Facility/Professional Professional Modifier Low / Median / High Price $4,231.72 / $7,375.88 / $8,868.82	Professional		$4,231.72	$7,375.88	$8,868.82
Medica Facility/Professional Facility Modifier Low / Median / High Price $3,625.96 / $7,390.68 / $31,266.85	Facility		$3,625.96	$7,390.68	$31,266.85
Medica Facility/Professional Professional Modifier Low / Median / High Price $3,329.15 / $4,887.57 / $8,047.54	Professional		$3,329.15	$4,887.57	$8,047.54
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 $2,094.67 / $5,592.48 / $8,499.28	Facility		$2,094.67	$5,592.48	$8,499.28
Prevea360 Facility/Professional Professional Modifier Low / Median / High Price $4,231.72 / $7,375.88 / $8,868.82	Professional		$4,231.72	$7,375.88	$8,868.82
Quartz Facility/Professional Professional Modifier Low / Median / High Price $7,390.68 / $11,374.03 / $19,468.77	Professional		$7,390.68	$11,374.03	$19,468.77
Quartz Facility/Professional Facility Modifier Low / Median / High Price $4,063.89 / $14,434.92 / $31,266.85	Facility		$4,063.89	$14,434.92	$31,266.85
Quartz Facility/Professional Professional Modifier Low / Median / High Price $3,454.31 / $4,063.89 / $36,700.76	Professional		$3,454.31	$4,063.89	$36,700.76
Security Health Facility/Professional Professional Modifier Low / Median / High Price $7,390.68 / $7,390.68 / $7,390.68	Professional		$7,390.68	$7,390.68	$7,390.68
Security Health Facility/Professional Professional Modifier Low / Median / High Price $7,390.68 / $7,390.68 / $7,390.68	Professional		$7,390.68	$7,390.68	$7,390.68
United Facility/Professional Professional Modifier Low / Median / High Price $2,703.86 / $4,326.17 / $7,390.68	Professional		$2,703.86	$4,326.17	$7,390.68