Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Professional Modifier Low / Median / High Price $1,134.71 / $1,134.71 / $1,134.71	Professional		$1,134.71	$1,134.71	$1,134.71
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $288.83 / $288.83 / $7,215.61	Professional		$288.83	$288.83	$7,215.61
CareSource Facility/Professional Facility Modifier Low / Median / High Price $2,653.42 / $2,653.42 / $2,653.42	Facility		$2,653.42	$2,653.42	$2,653.42
Cigna Facility/Professional Facility Modifier Low / Median / High Price $4,799.37 / $5,608.44 / $8,603.49	Facility		$4,799.37	$5,608.44	$8,603.49
Cigna Facility/Professional Professional Modifier Low / Median / High Price $2,063.98 / $4,696.10 / $5,336.49	Professional		$2,063.98	$4,696.10	$5,336.49
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $1,342.84 / $2,092.73 / $6,103.83	Facility		$1,342.84	$2,092.73	$6,103.83
Medica Facility/Professional Facility Modifier Low / Median / High Price $1,342.84 / $2,092.73 / $6,103.83	Facility		$1,342.84	$2,092.73	$6,103.83
Medica Facility/Professional Professional Modifier Low / Median / High Price $584.90 / $751.83 / $3,607.49	Professional		$584.90	$751.83	$3,607.49
Molina Facility/Professional Professional Modifier Low / Median / High Price $50.00 / $70.00 / $85.00	Professional		$50.00	$70.00	$85.00
Prevea360 Facility/Professional Facility Modifier Low / Median / High Price $1,342.84 / $2,092.73 / $6,103.83	Facility		$1,342.84	$2,092.73	$6,103.83
Quartz Facility/Professional Professional Modifier Low / Median / High Price $2,295.13 / $4,151.07 / $5,831.98	Professional		$2,295.13	$4,151.07	$5,831.98
Quartz Facility/Professional Facility Modifier Low / Median / High Price $3,487.90 / $8,283.76 / $8,283.76	Facility		$3,487.90	$8,283.76	$8,283.76
Quartz Facility/Professional Professional Modifier Low / Median / High Price $6,975.80 / $6,975.80 / $8,684.87	Professional		$6,975.80	$6,975.80	$8,684.87
Security Health Facility/Professional Professional Modifier Low / Median / High Price $3,713.82 / $3,713.82 / $3,713.82	Professional		$3,713.82	$3,713.82	$3,713.82
Security Health Facility/Professional Professional Modifier Low / Median / High Price $5,067.92 / $9,521.96 / $9,521.96	Professional		$5,067.92	$9,521.96	$9,521.96
United Facility/Professional Facility Modifier Low / Median / High Price $1,743.95 / $1,743.95 / $1,743.95	Facility		$1,743.95	$1,743.95	$1,743.95
United Facility/Professional Professional Modifier Low / Median / High Price $629.59 / $749.02 / $2,456.58	Professional		$629.59	$749.02	$2,456.58