Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $1,140.00 / $1,140.00 / $1,140.00	Facility		$1,140.00	$1,140.00	$1,140.00
Aetna Facility/Professional Professional Modifier Low / Median / High Price $779.00 / $893.00 / $1,140.00	Professional		$779.00	$893.00	$1,140.00
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $2,042.50 / $2,470.00 / $2,612.50	Facility		$2,042.50	$2,470.00	$2,612.50
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $336.26 / $336.26 / $3,800.00	Professional		$336.26	$336.26	$3,800.00
CareSource Facility/Professional Facility Modifier Low / Median / High Price $653.60 / $950.00 / $1,445.58	Facility		$653.60	$950.00	$1,445.58
Cigna Facility/Professional Facility Modifier Low / Median / High Price $2,614.15 / $3,054.84 / $4,686.20	Facility		$2,614.15	$3,054.84	$4,686.20
Cigna Facility/Professional Professional Modifier Low / Median / High Price $1,091.56 / $2,558.16 / $2,907.00	Professional		$1,091.56	$2,558.16	$2,907.00
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $503.50 / $855.00 / $1,216.00	Facility		$503.50	$855.00	$1,216.00
Medica Facility/Professional Facility Modifier Low / Median / High Price $503.50 / $950.00 / $4,512.50	Facility		$503.50	$950.00	$4,512.50
Medica Facility/Professional Professional Modifier Low / Median / High Price $551.00 / $950.00 / $1,995.00	Professional		$551.00	$950.00	$1,995.00
Molina Facility/Professional Professional Modifier Low / Median / High Price $55.00 / $65.00 / $85.00	Professional		$55.00	$65.00	$85.00
Prevea360 Facility/Professional Facility Modifier Low / Median / High Price $503.50 / $855.00 / $1,216.00	Facility		$503.50	$855.00	$1,216.00
Quartz Facility/Professional Professional Modifier Low / Median / High Price $1,116.06 / $2,265.31 / $3,230.70	Professional		$1,116.06	$2,265.31	$3,230.70
Quartz Facility/Professional Facility Modifier Low / Median / High Price $1,900.00 / $1,900.00 / $4,512.50	Facility		$1,900.00	$1,900.00	$4,512.50
Quartz Facility/Professional Professional Modifier Low / Median / High Price $503.50 / $503.50 / $503.50	Professional		$503.50	$503.50	$503.50
Security Health Facility/Professional Professional Modifier Low / Median / High Price $2,023.07 / $2,023.07 / $2,023.07	Professional		$2,023.07	$2,023.07	$2,023.07
Security Health Facility/Professional Professional Modifier Low / Median / High Price $4,987.50 / $5,187.00 / $5,187.00	Professional		$4,987.50	$5,187.00	$5,187.00
United Facility/Professional Professional Modifier Low / Median / High Price $513.00 / $760.00 / $1,768.33	Professional		$513.00	$760.00	$1,768.33