Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $900.00 / $900.00 / $900.00	Facility		$900.00	$900.00	$900.00
Aetna Facility/Professional Professional Modifier Low / Median / High Price $577.50 / $705.00 / $900.00	Professional		$577.50	$705.00	$900.00
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $336.26 / $336.26 / $3,000.00	Professional		$336.26	$336.26	$3,000.00
CareSource Facility/Professional Facility Modifier Low / Median / High Price $1,141.40 / $1,141.40 / $1,141.40	Facility		$1,141.40	$1,141.40	$1,141.40
Cigna Facility/Professional Facility Modifier Low / Median / High Price $2,063.56 / $2,411.44 / $3,699.21	Facility		$2,063.56	$2,411.44	$3,699.21
Cigna Facility/Professional Professional Modifier Low / Median / High Price $887.79 / $2,019.60 / $2,295.00	Professional		$887.79	$2,019.60	$2,295.00
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $577.50 / $900.00 / $2,625.00	Facility		$577.50	$900.00	$2,625.00
Medica Facility/Professional Facility Modifier Low / Median / High Price $577.50 / $900.00 / $2,625.00	Facility		$577.50	$900.00	$2,625.00
Medica Facility/Professional Professional Modifier Low / Median / High Price $375.00 / $450.00 / $2,312.89	Professional		$375.00	$450.00	$2,312.89
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 $577.50 / $900.00 / $2,625.00	Facility		$577.50	$900.00	$2,625.00
Quartz Facility/Professional Professional Modifier Low / Median / High Price $1,252.26 / $1,788.64 / $2,508.69	Professional		$1,252.26	$1,788.64	$2,508.69
Quartz Facility/Professional Facility Modifier Low / Median / High Price $1,500.00 / $3,562.50 / $3,562.50	Facility		$1,500.00	$3,562.50	$3,562.50
Quartz Facility/Professional Professional Modifier Low / Median / High Price $3,000.00 / $3,000.00 / $3,735.00	Professional		$3,000.00	$3,000.00	$3,735.00
Security Health Facility/Professional Professional Modifier Low / Median / High Price $1,597.16 / $1,597.16 / $1,597.16	Professional		$1,597.16	$1,597.16	$1,597.16
Security Health Facility/Professional Professional Modifier Low / Median / High Price $2,179.66 / $4,095.00 / $4,095.00	Professional		$2,179.66	$4,095.00	$4,095.00
United Facility/Professional Professional Modifier Low / Median / High Price $315.00 / $450.00 / $1,575.00	Professional		$315.00	$450.00	$1,575.00