Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Professional Modifier Low / Median / High Price $1,012.86 / $1,190.10 / $1,190.10	Professional		$1,012.86	$1,190.10	$1,190.10
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $1,440.00 / $1,440.00 / $5,422.84	Professional		$1,440.00	$1,440.00	$5,422.84
CareSource Facility/Professional Facility Modifier Low / Median / High Price $1,926.44 / $1,926.44 / $1,926.44	Facility		$1,926.44	$1,926.44	$1,926.44
Cigna Facility/Professional Facility Modifier Low / Median / High Price $3,484.63 / $4,072.07 / $6,246.66	Facility		$3,484.63	$4,072.07	$6,246.66
Cigna Facility/Professional Professional Modifier Low / Median / High Price $1,498.65 / $3,409.27 / $3,874.18	Professional		$1,498.65	$3,409.27	$3,874.18
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $974.87 / $1,519.28 / $4,431.25	Facility		$974.87	$1,519.28	$4,431.25
Medica Facility/Professional Facility Modifier Low / Median / High Price $974.87 / $1,519.28 / $4,431.25	Facility		$974.87	$1,519.28	$4,431.25
Medica Facility/Professional Professional Modifier Low / Median / High Price $633.04 / $759.64 / $3,904.37	Professional		$633.04	$759.64	$3,904.37
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 $974.87 / $1,519.28 / $4,431.25	Facility		$974.87	$1,519.28	$4,431.25
Quartz Facility/Professional Professional Modifier Low / Median / High Price $2,113.56 / $3,018.87 / $4,234.17	Professional		$2,113.56	$3,018.87	$4,234.17
Quartz Facility/Professional Facility Modifier Low / Median / High Price $2,916.60 / $6,013.83 / $6,013.83	Facility		$2,916.60	$6,013.83	$6,013.83
Quartz Facility/Professional Professional Modifier Low / Median / High Price $5,064.28 / $5,064.28 / $6,305.03	Professional		$5,064.28	$5,064.28	$6,305.03
Security Health Facility/Professional Professional Modifier Low / Median / High Price $2,696.73 / $2,696.73 / $2,696.73	Professional		$2,696.73	$2,696.73	$2,696.73
Security Health Facility/Professional Professional Modifier Low / Median / High Price $6,912.74 / $6,912.74 / $6,912.74	Professional		$6,912.74	$6,912.74	$6,912.74
United Facility/Professional Professional Modifier Low / Median / High Price $550.36 / $759.64 / $2,356.66	Professional		$550.36	$759.64	$2,356.66