Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $2,106.00 / $2,106.00 / $2,106.00	Facility		$2,106.00	$2,106.00	$2,106.00
Aetna Facility/Professional Professional Modifier Low / Median / High Price $1,351.35 / $1,667.25 / $2,106.00	Professional		$1,351.35	$1,667.25	$2,106.00
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $336.26 / $336.26 / $7,800.00	Professional		$336.26	$336.26	$7,800.00
CareSource Facility/Professional Facility Modifier Low / Median / High Price $2,966.94 / $2,966.94 / $2,966.94	Facility		$2,966.94	$2,966.94	$2,966.94
Cigna Facility/Professional Facility Modifier Low / Median / High Price $5,366.17 / $6,270.79 / $9,619.56	Facility		$5,366.17	$6,270.79	$9,619.56
Cigna Facility/Professional Professional Modifier Low / Median / High Price $2,307.73 / $5,250.96 / $5,967.00	Professional		$2,307.73	$5,250.96	$5,967.00
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $1,351.35 / $2,145.00 / $6,825.00	Facility		$1,351.35	$2,145.00	$6,825.00
Medica Facility/Professional Facility Modifier Low / Median / High Price $1,351.35 / $2,340.00 / $6,825.00	Facility		$1,351.35	$2,340.00	$6,825.00
Medica Facility/Professional Professional Modifier Low / Median / High Price $877.50 / $1,127.94 / $5,412.16	Professional		$877.50	$1,127.94	$5,412.16
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 $1,351.35 / $2,145.00 / $6,825.00	Facility		$1,351.35	$2,145.00	$6,825.00
Quartz Facility/Professional Professional Modifier Low / Median / High Price $3,255.12 / $4,649.39 / $6,521.09	Professional		$3,255.12	$4,649.39	$6,521.09
Quartz Facility/Professional Facility Modifier Low / Median / High Price $3,900.00 / $9,262.50 / $9,262.50	Facility		$3,900.00	$9,262.50	$9,262.50
Quartz Facility/Professional Professional Modifier Low / Median / High Price $7,800.00 / $7,800.00 / $9,711.00	Professional		$7,800.00	$7,800.00	$9,711.00
Security Health Facility/Professional Professional Modifier Low / Median / High Price $3,737.35 / $3,737.35 / $3,737.35	Professional		$3,737.35	$3,737.35	$3,737.35
Security Health Facility/Professional Professional Modifier Low / Median / High Price $5,666.70 / $10,647.00 / $10,647.00	Professional		$5,666.70	$10,647.00	$10,647.00
United Facility/Professional Facility Modifier Low / Median / High Price $1,950.00 / $1,950.00 / $1,950.00	Facility		$1,950.00	$1,950.00	$1,950.00
United Facility/Professional Professional Modifier Low / Median / High Price $877.50 / $1,123.73 / $3,685.50	Professional		$877.50	$1,123.73	$3,685.50