Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $3,281.78 / $3,281.78 / $3,281.78	Facility		$3,281.78	$3,281.78	$3,281.78
Aetna Facility/Professional Professional Modifier Low / Median / High Price $2,653.28 / $3,281.78 / $5,449.00	Professional		$2,653.28	$3,281.78	$5,449.00
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $6,505.50 / $7,156.05 / $11,840.01	Facility		$6,505.50	$7,156.05	$11,840.01
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $6,050.12 / $6,050.12 / $8,001.76	Professional		$6,050.12	$6,050.12	$8,001.76
CareSource Facility/Professional Facility Modifier Low / Median / High Price $4,680.05 / $13,921.77 / $13,921.77	Facility		$4,680.05	$13,921.77	$13,921.77
Cigna Facility/Professional Facility Modifier Low / Median / High Price $3,799.01 / $13,751.17 / $27,154.34	Facility		$3,799.01	$13,751.17	$27,154.34
Cigna Facility/Professional Professional Modifier Low / Median / High Price $3,229.16 / $9,578.34 / $12,312.18	Professional		$3,229.16	$9,578.34	$12,312.18
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $1,843.79 / $4,922.67 / $7,481.33	Facility		$1,843.79	$4,922.67	$7,481.33
DeanCare Facility/Professional Professional Modifier Low / Median / High Price $3,724.89 / $6,492.48 / $7,806.60	Professional		$3,724.89	$6,492.48	$7,806.60
Medica Facility/Professional Facility Modifier Low / Median / High Price $3,191.67 / $6,505.50 / $27,521.96	Facility		$3,191.67	$6,505.50	$27,521.96
Medica Facility/Professional Professional Modifier Low / Median / High Price $2,930.42 / $4,302.18 / $7,083.69	Professional		$2,930.42	$4,302.18	$7,083.69
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 $1,843.79 / $4,922.67 / $7,481.33	Facility		$1,843.79	$4,922.67	$7,481.33
Prevea360 Facility/Professional Professional Modifier Low / Median / High Price $3,724.89 / $6,492.48 / $7,806.60	Professional		$3,724.89	$6,492.48	$7,806.60
Quartz Facility/Professional Professional Modifier Low / Median / High Price $6,505.50 / $10,011.76 / $17,136.16	Professional		$6,505.50	$10,011.76	$17,136.16
Quartz Facility/Professional Facility Modifier Low / Median / High Price $3,799.01 / $12,706.06 / $27,521.96	Facility		$3,799.01	$12,706.06	$27,521.96
Quartz Facility/Professional Professional Modifier Low / Median / High Price $3,229.16 / $3,799.01 / $32,305.11	Professional		$3,229.16	$3,799.01	$32,305.11
Security Health Facility/Professional Professional Modifier Low / Median / High Price $6,505.50 / $6,505.50 / $6,505.50	Professional		$6,505.50	$6,505.50	$6,505.50
Security Health Facility/Professional Professional Modifier Low / Median / High Price $6,505.50 / $6,505.50 / $6,505.50	Professional		$6,505.50	$6,505.50	$6,505.50
United Facility/Professional Professional Modifier Low / Median / High Price $2,581.31 / $3,808.02 / $5,767.89	Professional		$2,581.31	$3,808.02	$5,767.89