Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $2,325.61 / $2,325.61 / $2,325.61	Facility		$2,325.61	$2,325.61	$2,325.61
Aetna Facility/Professional Professional Modifier Low / Median / High Price $1,492.27 / $1,821.73 / $2,325.61	Professional		$1,492.27	$1,821.73	$2,325.61
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $33.47 / $33.47 / $7,752.04	Professional		$33.47	$33.47	$7,752.04
CareSource Facility/Professional Facility Modifier Low / Median / High Price $2,948.73 / $2,948.73 / $2,948.73	Facility		$2,948.73	$2,948.73	$2,948.73
Cigna Facility/Professional Facility Modifier Low / Median / High Price $5,333.73 / $6,232.88 / $9,561.40	Facility		$5,333.73	$6,232.88	$9,561.40
Cigna Facility/Professional Professional Modifier Low / Median / High Price $2,293.69 / $5,218.68 / $5,930.31	Professional		$2,293.69	$5,218.68	$5,930.31
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $1,492.27 / $2,325.61 / $6,783.04	Facility		$1,492.27	$2,325.61	$6,783.04
Medica Facility/Professional Facility Modifier Low / Median / High Price $1,492.27 / $2,325.61 / $6,783.04	Facility		$1,492.27	$2,325.61	$6,783.04
Medica Facility/Professional Professional Modifier Low / Median / High Price $969.01 / $1,162.81 / $5,976.53	Professional		$969.01	$1,162.81	$5,976.53
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 $1,492.27 / $2,325.61 / $6,783.04	Facility		$1,492.27	$2,325.61	$6,783.04
Quartz Facility/Professional Professional Modifier Low / Median / High Price $3,235.14 / $4,620.85 / $6,481.06	Professional		$3,235.14	$4,620.85	$6,481.06
Quartz Facility/Professional Facility Modifier Low / Median / High Price $3,876.02 / $9,205.54 / $9,205.54	Facility		$3,876.02	$9,205.54	$9,205.54
Quartz Facility/Professional Professional Modifier Low / Median / High Price $7,752.04 / $7,752.04 / $9,651.29	Professional		$7,752.04	$7,752.04	$9,651.29
Security Health Facility/Professional Professional Modifier Low / Median / High Price $4,127.08 / $4,127.08 / $4,127.08	Professional		$4,127.08	$4,127.08	$4,127.08
Security Health Facility/Professional Professional Modifier Low / Median / High Price $5,632.27 / $10,581.53 / $10,581.53	Professional		$5,632.27	$10,581.53	$10,581.53
United Facility/Professional Professional Modifier Low / Median / High Price $842.45 / $1,162.81 / $4,069.82	Professional		$842.45	$1,162.81	$4,069.82