Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Professional Modifier Low / Median / High Price $4,179.68 / $4,911.12 / $4,911.12	Professional		$4,179.68	$4,911.12	$4,911.12
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $1,912.00 / $1,912.00 / $21,616.84	Professional		$1,912.00	$1,912.00	$21,616.84
CareSource Facility/Professional Facility Modifier Low / Median / High Price $7,949.92 / $7,949.92 / $7,949.92	Facility		$7,949.92	$7,949.92	$7,949.92
Cigna Facility/Professional Facility Modifier Low / Median / High Price $14,378.27 / $16,802.15 / $25,774.92	Facility		$14,378.27	$16,802.15	$25,774.92
Cigna Facility/Professional Professional Modifier Low / Median / High Price $6,183.89 / $14,068.80 / $15,987.28	Professional		$6,183.89	$14,068.80	$15,987.28
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $4,022.94 / $6,269.52 / $18,286.09	Facility		$4,022.94	$6,269.52	$18,286.09
Medica Facility/Professional Facility Modifier Low / Median / High Price $4,022.94 / $6,269.52 / $18,286.09	Facility		$4,022.94	$6,269.52	$18,286.09
Medica Facility/Professional Professional Modifier Low / Median / High Price $2,612.30 / $3,134.76 / $16,111.88	Professional		$2,612.30	$3,134.76	$16,111.88
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 $4,022.94 / $6,269.52 / $18,286.09	Facility		$4,022.94	$6,269.52	$18,286.09
Quartz Facility/Professional Professional Modifier Low / Median / High Price $8,722.08 / $12,458.04 / $17,473.23	Professional		$8,722.08	$12,458.04	$17,473.23
Quartz Facility/Professional Facility Modifier Low / Median / High Price $10,449.20 / $24,816.85 / $24,816.85	Facility		$10,449.20	$24,816.85	$24,816.85
Quartz Facility/Professional Professional Modifier Low / Median / High Price $20,898.40 / $20,898.40 / $26,018.51	Professional		$20,898.40	$20,898.40	$26,018.51
Security Health Facility/Professional Professional Modifier Low / Median / High Price $11,126.01 / $11,126.01 / $11,126.01	Professional		$11,126.01	$11,126.01	$11,126.01
Security Health Facility/Professional Professional Modifier Low / Median / High Price $28,526.32 / $28,526.32 / $28,526.32	Professional		$28,526.32	$28,526.32	$28,526.32
United Facility/Professional Facility Modifier Low / Median / High Price $6,269.52 / $6,269.52 / $6,269.52	Facility		$6,269.52	$6,269.52	$6,269.52
United Facility/Professional Professional Modifier Low / Median / High Price $2,612.30 / $3,134.76 / $9,725.07	Professional		$2,612.30	$3,134.76	$9,725.07