Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $1,822.87 / $1,822.87 / $1,822.87	Facility		$1,822.87	$1,822.87	$1,822.87
Aetna Facility/Professional Professional Modifier Low / Median / High Price $1,169.68 / $1,427.92 / $1,822.87	Professional		$1,169.68	$1,427.92	$1,822.87
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $239.16 / $239.16 / $6,285.12	Professional		$239.16	$239.16	$6,285.12
CareSource Facility/Professional Facility Modifier Low / Median / High Price $2,311.34 / $2,311.34 / $2,311.34	Facility		$2,311.34	$2,311.34	$2,311.34
Cigna Facility/Professional Facility Modifier Low / Median / High Price $4,180.30 / $4,885.01 / $7,493.72	Facility		$4,180.30	$4,885.01	$7,493.72
Cigna Facility/Professional Professional Modifier Low / Median / High Price $1,797.70 / $4,090.53 / $4,648.33	Professional		$1,797.70	$4,090.53	$4,648.33
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $1,169.68 / $1,822.87 / $5,316.71	Facility		$1,169.68	$1,822.87	$5,316.71
Medica Facility/Professional Facility Modifier Low / Median / High Price $1,169.68 / $1,822.87 / $5,316.71	Facility		$1,169.68	$1,822.87	$5,316.71
Medica Facility/Professional Professional Modifier Low / Median / High Price $759.53 / $911.44 / $4,684.55	Professional		$759.53	$911.44	$4,684.55
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 $1,169.68 / $1,822.87 / $5,316.71	Facility		$1,169.68	$1,822.87	$5,316.71
Quartz Facility/Professional Professional Modifier Low / Median / High Price $2,535.84 / $3,622.02 / $5,080.13	Professional		$2,535.84	$3,622.02	$5,080.13
Quartz Facility/Professional Facility Modifier Low / Median / High Price $3,038.12 / $7,215.54 / $7,215.54	Facility		$3,038.12	$7,215.54	$7,215.54
Quartz Facility/Professional Professional Modifier Low / Median / High Price $6,076.24 / $6,076.24 / $7,564.92	Professional		$6,076.24	$6,076.24	$7,564.92
Security Health Facility/Professional Professional Modifier Low / Median / High Price $3,234.90 / $3,234.90 / $3,234.90	Professional		$3,234.90	$3,234.90	$3,234.90
Security Health Facility/Professional Professional Modifier Low / Median / High Price $8,294.07 / $8,294.07 / $8,294.07	Professional		$8,294.07	$8,294.07	$8,294.07
United Facility/Professional Professional Modifier Low / Median / High Price $759.53 / $911.44 / $3,190.03	Professional		$759.53	$911.44	$3,190.03