Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $2,897.06 / $2,897.06 / $2,897.06	Facility		$2,897.06	$2,897.06	$2,897.06
Aetna Facility/Professional Professional Modifier Low / Median / High Price $2,405.30 / $2,897.06 / $4,853.70	Professional		$2,405.30	$2,897.06	$4,853.70
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $5,742.88 / $6,317.17 / $10,452.04	Facility		$5,742.88	$6,317.17	$10,452.04
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $5,281.10 / $5,340.88 / $7,063.74	Professional		$5,281.10	$5,340.88	$7,063.74
CareSource Facility/Professional Facility Modifier Low / Median / High Price $4,131.41 / $12,289.76 / $12,289.76	Facility		$4,131.41	$12,289.76	$12,289.76
Cigna Facility/Professional Facility Modifier Low / Median / High Price $4,536.46 / $17,128.00 / $23,971.73	Facility		$4,536.46	$17,128.00	$23,971.73
Cigna Facility/Professional Professional Modifier Low / Median / High Price $3,855.99 / $8,322.19 / $10,868.85	Professional		$3,855.99	$8,322.19	$10,868.85
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $1,652.75 / $4,345.59 / $6,604.31	Facility		$1,652.75	$4,345.59	$6,604.31
DeanCare Facility/Professional Professional Modifier Low / Median / High Price $3,288.24 / $5,605.27 / $6,891.46	Professional		$3,288.24	$5,605.27	$6,891.46
Medica Facility/Professional Facility Modifier Low / Median / High Price $2,745.12 / $5,742.88 / $26,749.15	Facility		$2,745.12	$5,742.88	$26,749.15
Medica Facility/Professional Professional Modifier Low / Median / High Price $2,635.98 / $3,840.20 / $6,253.29	Professional		$2,635.98	$3,840.20	$6,253.29
Molina Facility/Professional Professional Modifier Low / Median / High Price $50.00 / $70.00 / $4,543.97	Professional		$50.00	$70.00	$4,543.97
Prevea360 Facility/Professional Facility Modifier Low / Median / High Price $1,652.75 / $4,432.50 / $6,604.31	Facility		$1,652.75	$4,432.50	$6,604.31
Prevea360 Facility/Professional Professional Modifier Low / Median / High Price $3,288.24 / $5,605.27 / $6,891.46	Professional		$3,288.24	$5,605.27	$6,891.46
Quartz Facility/Professional Professional Modifier Low / Median / High Price $5,742.88 / $8,838.10 / $15,360.62	Professional		$5,742.88	$8,838.10	$15,360.62
Quartz Facility/Professional Facility Modifier Low / Median / High Price $4,536.46 / $11,216.56 / $26,749.15	Facility		$4,536.46	$11,216.56	$26,749.15
Quartz Facility/Professional Professional Modifier Low / Median / High Price $3,855.99 / $4,536.46 / $28,971.25	Professional		$3,855.99	$4,536.46	$28,971.25
Security Health Facility/Professional Professional Modifier Low / Median / High Price $5,742.88 / $5,742.88 / $5,742.88	Professional		$5,742.88	$5,742.88	$5,742.88
Security Health Facility/Professional Professional Modifier Low / Median / High Price $5,742.88 / $5,742.88 / $5,742.88	Professional		$5,742.88	$5,742.88	$5,742.88
United Facility/Professional Professional Modifier Low / Median / High Price $2,004.52 / $3,445.73 / $5,091.72	Professional		$2,004.52	$3,445.73	$5,091.72