Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Professional Modifier Low / Median / High Price $1,517.60 / $1,783.18 / $3,600.00	Professional		$1,517.60	$1,783.18	$3,600.00
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $1,549.20 / $1,549.20 / $7,588.00	Professional		$1,549.20	$1,549.20	$7,588.00
CareSource Facility/Professional Facility Modifier Low / Median / High Price $2,886.72 / $2,886.72 / $2,886.72	Facility		$2,886.72	$2,886.72	$2,886.72
Cigna Facility/Professional Facility Modifier Low / Median / High Price $5,220.18 / $6,100.20 / $9,357.87	Facility		$5,220.18	$6,100.20	$9,357.87
Cigna Facility/Professional Professional Modifier Low / Median / High Price $2,245.63 / $5,108.25 / $5,804.83	Professional		$2,245.63	$5,108.25	$5,804.83
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $1,460.69 / $2,276.40 / $6,639.50	Facility		$1,460.69	$2,276.40	$6,639.50
Medica Facility/Professional Facility Modifier Low / Median / High Price $1,460.69 / $2,276.40 / $6,639.50	Facility		$1,460.69	$2,276.40	$6,639.50
Medica Facility/Professional Professional Modifier Low / Median / High Price $948.50 / $1,138.20 / $5,850.06	Professional		$948.50	$1,138.20	$5,850.06
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 $1,460.69 / $2,276.40 / $6,639.50	Facility		$1,460.69	$2,276.40	$6,639.50
Quartz Facility/Professional Professional Modifier Low / Median / High Price $3,167.10 / $4,523.67 / $6,344.76	Professional		$3,167.10	$4,523.67	$6,344.76
Quartz Facility/Professional Facility Modifier Low / Median / High Price $3,794.00 / $9,010.75 / $9,010.75	Facility		$3,794.00	$9,010.75	$9,010.75
Quartz Facility/Professional Professional Modifier Low / Median / High Price $7,588.00 / $7,588.00 / $9,447.06	Professional		$7,588.00	$7,588.00	$9,447.06
Security Health Facility/Professional Professional Modifier Low / Median / High Price $4,039.74 / $4,039.74 / $4,039.74	Professional		$4,039.74	$4,039.74	$4,039.74
Security Health Facility/Professional Professional Modifier Low / Median / High Price $5,513.09 / $10,357.62 / $10,357.62	Professional		$5,513.09	$10,357.62	$10,357.62
United Facility/Professional Professional Modifier Low / Median / High Price $853.65 / $1,138.20 / $3,983.70	Professional		$853.65	$1,138.20	$3,983.70