Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $1,050.48 / $1,050.48 / $1,050.48	Facility		$1,050.48	$1,050.48	$1,050.48
Aetna Facility/Professional Professional Modifier Low / Median / High Price $872.16 / $1,050.48 / $1,759.94	Professional		$872.16	$1,050.48	$1,759.94
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $2,082.38 / $2,290.62 / $3,789.93	Facility		$2,082.38	$2,290.62	$3,789.93
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $1,838.80 / $1,936.61 / $2,561.32	Professional		$1,838.80	$1,936.61	$2,561.32
CareSource Facility/Professional Facility Modifier Low / Median / High Price $1,498.06 / $4,456.29 / $4,456.29	Facility		$1,498.06	$4,456.29	$4,456.29
Cigna Facility/Professional Facility Modifier Low / Median / High Price $1,162.68 / $4,597.41 / $8,692.69	Facility		$1,162.68	$4,597.41	$8,692.69
Cigna Facility/Professional Professional Modifier Low / Median / High Price $988.28 / $3,066.10 / $3,941.06	Professional		$988.28	$3,066.10	$3,941.06
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $599.29 / $1,575.72 / $2,394.73	Facility		$599.29	$1,575.72	$2,394.73
DeanCare Facility/Professional Professional Modifier Low / Median / High Price $1,192.32 / $2,032.46 / $2,498.86	Professional		$1,192.32	$2,032.46	$2,498.86
Medica Facility/Professional Facility Modifier Low / Median / High Price $1,037.39 / $2,082.38 / $9,699.25	Facility		$1,037.39	$2,082.38	$9,699.25
Medica Facility/Professional Professional Modifier Low / Median / High Price $773.58 / $1,237.72 / $2,267.44	Professional		$773.58	$1,237.72	$2,267.44
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 $599.29 / $1,575.72 / $2,394.73	Facility		$599.29	$1,575.72	$2,394.73
Prevea360 Facility/Professional Professional Modifier Low / Median / High Price $1,192.32 / $2,032.46 / $2,498.86	Professional		$1,192.32	$2,032.46	$2,498.86
Quartz Facility/Professional Professional Modifier Low / Median / High Price $2,082.38 / $3,204.71 / $5,569.53	Professional		$2,082.38	$3,204.71	$5,569.53
Quartz Facility/Professional Facility Modifier Low / Median / High Price $1,162.68 / $4,067.14 / $9,699.25	Facility		$1,162.68	$4,067.14	$9,699.25
Quartz Facility/Professional Professional Modifier Low / Median / High Price $988.28 / $1,162.68 / $10,504.91	Professional		$988.28	$1,162.68	$10,504.91
Security Health Facility/Professional Professional Modifier Low / Median / High Price $2,082.38 / $2,082.38 / $2,082.38	Professional		$2,082.38	$2,082.38	$2,082.38
Security Health Facility/Professional Professional Modifier Low / Median / High Price $2,082.38 / $2,082.38 / $2,082.38	Professional		$2,082.38	$2,082.38	$2,082.38
United Facility/Professional Professional Modifier Low / Median / High Price $726.84 / $1,090.82 / $1,846.27	Professional		$726.84	$1,090.82	$1,846.27