Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Professional Modifier Low / Median / High Price $2,500.00 / $2,500.00 / $2,500.00	Professional		$2,500.00	$2,500.00	$2,500.00
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $1,440.00 / $1,440.00 / $12,008.36	Professional		$1,440.00	$1,440.00	$12,008.36
CareSource Facility/Professional Facility Modifier Low / Median / High Price $4,568.05 / $4,568.05 / $4,568.05	Facility		$4,568.05	$4,568.05	$4,568.05
Cigna Facility/Professional Facility Modifier Low / Median / High Price $8,261.46 / $9,654.18 / $14,809.76	Facility		$8,261.46	$9,654.18	$14,809.76
Cigna Facility/Professional Professional Modifier Low / Median / High Price $3,553.28 / $8,084.03 / $9,186.40	Professional		$3,553.28	$8,084.03	$9,186.40
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $2,311.61 / $3,602.51 / $10,507.32	Facility		$2,311.61	$3,602.51	$10,507.32
Medica Facility/Professional Facility Modifier Low / Median / High Price $2,311.61 / $3,602.51 / $10,507.32	Facility		$2,311.61	$3,602.51	$10,507.32
Medica Facility/Professional Professional Modifier Low / Median / High Price $1,501.05 / $1,801.25 / $9,258.00	Professional		$1,501.05	$1,801.25	$9,258.00
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 $2,311.61 / $3,602.51 / $10,507.32	Facility		$2,311.61	$3,602.51	$10,507.32
Quartz Facility/Professional Professional Modifier Low / Median / High Price $5,011.74 / $7,158.44 / $10,040.19	Professional		$5,011.74	$7,158.44	$10,040.19
Quartz Facility/Professional Facility Modifier Low / Median / High Price $6,004.18 / $14,259.93 / $14,259.93	Facility		$6,004.18	$14,259.93	$14,259.93
Quartz Facility/Professional Professional Modifier Low / Median / High Price $12,008.36 / $15,010.45 / $15,010.45	Professional		$12,008.36	$15,010.45	$15,010.45
Security Health Facility/Professional Professional Modifier Low / Median / High Price $6,393.08 / $6,393.08 / $6,393.08	Professional		$6,393.08	$6,393.08	$6,393.08
Security Health Facility/Professional Professional Modifier Low / Median / High Price $8,724.71 / $16,391.41 / $16,391.41	Professional		$8,724.71	$16,391.41	$16,391.41
United Facility/Professional Professional Modifier Low / Median / High Price $1,305.01 / $1,801.25 / $5,588.09	Professional		$1,305.01	$1,801.25	$5,588.09