Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $3,888.00 / $3,888.00 / $3,888.00	Facility		$3,888.00	$3,888.00	$3,888.00
Aetna Facility/Professional Professional Modifier Low / Median / High Price $2,494.80 / $3,045.60 / $3,888.00	Professional		$2,494.80	$3,045.60	$3,888.00
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $1,296.00 / $1,296.00 / $12,960.00	Professional		$1,296.00	$1,296.00	$12,960.00
CareSource Facility/Professional Facility Modifier Low / Median / High Price $4,930.30 / $4,930.30 / $4,930.30	Facility		$4,930.30	$4,930.30	$4,930.30
Cigna Facility/Professional Facility Modifier Low / Median / High Price $8,916.58 / $10,419.73 / $15,984.14	Facility		$8,916.58	$10,419.73	$15,984.14
Cigna Facility/Professional Professional Modifier Low / Median / High Price $3,834.47 / $8,724.67 / $9,914.40	Professional		$3,834.47	$8,724.67	$9,914.40
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $2,494.80 / $3,888.00 / $11,340.00	Facility		$2,494.80	$3,888.00	$11,340.00
Medica Facility/Professional Facility Modifier Low / Median / High Price $2,494.80 / $3,888.00 / $11,340.00	Facility		$2,494.80	$3,888.00	$11,340.00
Medica Facility/Professional Professional Modifier Low / Median / High Price $1,620.00 / $1,944.00 / $9,991.67	Professional		$1,620.00	$1,944.00	$9,991.67
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 $2,494.80 / $3,888.00 / $11,340.00	Facility		$2,494.80	$3,888.00	$11,340.00
Quartz Facility/Professional Professional Modifier Low / Median / High Price $5,409.18 / $7,726.11 / $10,836.39	Professional		$5,409.18	$7,726.11	$10,836.39
Quartz Facility/Professional Facility Modifier Low / Median / High Price $6,480.00 / $15,390.00 / $15,390.00	Facility		$6,480.00	$15,390.00	$15,390.00
Quartz Facility/Professional Professional Modifier Low / Median / High Price $12,960.00 / $16,200.00 / $16,200.00	Professional		$12,960.00	$16,200.00	$16,200.00
Security Health Facility/Professional Professional Modifier Low / Median / High Price $6,899.72 / $6,899.72 / $6,899.72	Professional		$6,899.72	$6,899.72	$6,899.72
Security Health Facility/Professional Professional Modifier Low / Median / High Price $9,416.12 / $17,690.40 / $17,690.40	Professional		$9,416.12	$17,690.40	$17,690.40
United Facility/Professional Professional Modifier Low / Median / High Price $1,458.00 / $1,944.00 / $7,980.81	Professional		$1,458.00	$1,944.00	$7,980.81