Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $1,048.77 / $1,048.77 / $1,048.77	Facility		$1,048.77	$1,048.77	$1,048.77
Aetna Facility/Professional Professional Modifier Low / Median / High Price $870.75 / $1,048.77 / $1,757.11	Professional		$870.75	$1,048.77	$1,757.11
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $2,079.00 / $2,286.90 / $3,783.78	Facility		$2,079.00	$2,286.90	$3,783.78
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $1,933.47 / $2,079.00 / $2,557.17	Professional		$1,933.47	$2,079.00	$2,557.17
CareSource Facility/Professional Facility Modifier Low / Median / High Price $1,495.62 / $4,449.06 / $4,449.06	Facility		$1,495.62	$4,449.06	$4,449.06
Cigna Facility/Professional Facility Modifier Low / Median / High Price $1,650.90 / $6,654.75 / $8,677.29	Facility		$1,650.90	$6,654.75	$8,677.29
Cigna Facility/Professional Professional Modifier Low / Median / High Price $1,403.27 / $3,012.66 / $3,934.66	Professional		$1,403.27	$3,012.66	$3,934.66
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $926.42 / $1,573.16 / $2,390.85	Facility		$926.42	$1,573.16	$2,390.85
DeanCare Facility/Professional Professional Modifier Low / Median / High Price $1,843.18 / $2,029.15 / $2,494.80	Professional		$1,843.18	$2,029.15	$2,494.80
Medica Facility/Professional Facility Modifier Low / Median / High Price $1,048.77 / $2,079.00 / $9,683.48	Facility		$1,048.77	$2,079.00	$9,683.48
Medica Facility/Professional Professional Modifier Low / Median / High Price $1,037.18 / $1,674.70 / $2,494.80	Professional		$1,037.18	$1,674.70	$2,494.80
Molina Facility/Professional Professional Modifier Low / Median / High Price $50.00 / $70.00 / $1,339.76	Professional		$50.00	$70.00	$1,339.76
Prevea360 Facility/Professional Facility Modifier Low / Median / High Price $926.42 / $1,604.62 / $2,390.85	Facility		$926.42	$1,604.62	$2,390.85
Prevea360 Facility/Professional Professional Modifier Low / Median / High Price $1,843.18 / $2,029.15 / $2,494.80	Professional		$1,843.18	$2,029.15	$2,494.80
Quartz Facility/Professional Professional Modifier Low / Median / High Price $2,079.00 / $3,199.49 / $5,560.50	Professional		$2,079.00	$3,199.49	$5,560.50
Quartz Facility/Professional Facility Modifier Low / Median / High Price $1,650.90 / $4,060.54 / $9,683.48	Facility		$1,650.90	$4,060.54	$9,683.48
Quartz Facility/Professional Professional Modifier Low / Median / High Price $1,403.27 / $1,650.90 / $10,487.98	Professional		$1,403.27	$1,650.90	$10,487.98
Security Health Facility/Professional Professional Modifier Low / Median / High Price $2,079.00 / $2,079.00 / $2,079.00	Professional		$2,079.00	$2,079.00	$2,079.00
Security Health Facility/Professional Professional Modifier Low / Median / High Price $2,079.00 / $2,079.00 / $2,079.00	Professional		$2,079.00	$2,079.00	$2,079.00
United Facility/Professional Facility Modifier Low / Median / High Price $2.29 / $2,159.48 / $2,162.13	Facility		$2.29	$2,159.48	$2,162.13
United Facility/Professional Professional Modifier Low / Median / High Price $772.32 / $1,496.73 / $2,303.96	Professional		$772.32	$1,496.73	$2,303.96