Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Professional Modifier Low / Median / High Price $1,392.00 / $1,635.60 / $1,635.60	Professional		$1,392.00	$1,635.60	$1,635.60
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $846.27 / $846.27 / $7,199.27	Professional		$846.27	$846.27	$7,199.27
CareSource Facility/Professional Facility Modifier Low / Median / High Price $2,647.51 / $2,647.51 / $2,647.51	Facility		$2,647.51	$2,647.51	$2,647.51
Cigna Facility/Professional Facility Modifier Low / Median / High Price $4,788.55 / $5,595.80 / $8,584.10	Facility		$4,788.55	$5,595.80	$8,584.10
Cigna Facility/Professional Professional Modifier Low / Median / High Price $2,059.31 / $4,685.47 / $5,324.40	Professional		$2,059.31	$4,685.47	$5,324.40
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $1,339.80 / $2,088.00 / $6,090.00	Facility		$1,339.80	$2,088.00	$6,090.00
Medica Facility/Professional Facility Modifier Low / Median / High Price $1,339.80 / $2,088.00 / $6,090.00	Facility		$1,339.80	$2,088.00	$6,090.00
Medica Facility/Professional Professional Modifier Low / Median / High Price $870.00 / $1,044.00 / $5,365.90	Professional		$870.00	$1,044.00	$5,365.90
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 $1,339.80 / $2,088.00 / $6,090.00	Facility		$1,339.80	$2,088.00	$6,090.00
Quartz Facility/Professional Professional Modifier Low / Median / High Price $2,904.66 / $4,148.82 / $5,819.00	Professional		$2,904.66	$4,148.82	$5,819.00
Quartz Facility/Professional Facility Modifier Low / Median / High Price $3,480.00 / $8,265.00 / $8,265.00	Facility		$3,480.00	$8,265.00	$8,265.00
Quartz Facility/Professional Professional Modifier Low / Median / High Price $6,960.00 / $6,960.00 / $8,665.20	Professional		$6,960.00	$6,960.00	$8,665.20
Security Health Facility/Professional Professional Modifier Low / Median / High Price $3,705.41 / $3,705.41 / $3,705.41	Professional		$3,705.41	$3,705.41	$3,705.41
Security Health Facility/Professional Professional Modifier Low / Median / High Price $9,500.40 / $9,500.40 / $9,500.40	Professional		$9,500.40	$9,500.40	$9,500.40
United Facility/Professional Facility Modifier Low / Median / High Price $1,740.00 / $1,740.00 / $1,740.00	Facility		$1,740.00	$1,740.00	$1,740.00
United Facility/Professional Professional Modifier Low / Median / High Price $756.38 / $1,044.00 / $3,654.00	Professional		$756.38	$1,044.00	$3,654.00