Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Professional Modifier Low / Median / High Price $2,560.00 / $3,008.00 / $3,008.00	Professional		$2,560.00	$3,008.00	$3,008.00
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $1,148.40 / $1,148.40 / $13,240.03	Professional		$1,148.40	$1,148.40	$13,240.03
CareSource Facility/Professional Facility Modifier Low / Median / High Price $4,869.28 / $4,869.28 / $4,869.28	Facility		$4,869.28	$4,869.28	$4,869.28
Cigna Facility/Professional Facility Modifier Low / Median / High Price $8,806.65 / $10,291.26 / $15,787.06	Facility		$8,806.65	$10,291.26	$15,787.06
Cigna Facility/Professional Professional Modifier Low / Median / High Price $3,787.67 / $8,616.95 / $9,792.00	Professional		$3,787.67	$8,616.95	$9,792.00
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $2,464.00 / $3,840.00 / $11,200.00	Facility		$2,464.00	$3,840.00	$11,200.00
Medica Facility/Professional Facility Modifier Low / Median / High Price $2,464.00 / $3,840.00 / $11,200.00	Facility		$2,464.00	$3,840.00	$11,200.00
Medica Facility/Professional Professional Modifier Low / Median / High Price $1,600.00 / $1,920.00 / $9,868.32	Professional		$1,600.00	$1,920.00	$9,868.32
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 $2,464.00 / $3,840.00 / $11,200.00	Facility		$2,464.00	$3,840.00	$11,200.00
Quartz Facility/Professional Professional Modifier Low / Median / High Price $5,342.22 / $7,630.47 / $10,702.25	Professional		$5,342.22	$7,630.47	$10,702.25
Quartz Facility/Professional Facility Modifier Low / Median / High Price $6,400.00 / $15,200.00 / $15,200.00	Facility		$6,400.00	$15,200.00	$15,200.00
Quartz Facility/Professional Professional Modifier Low / Median / High Price $12,800.00 / $12,800.00 / $15,936.00	Professional		$12,800.00	$12,800.00	$15,936.00
Security Health Facility/Professional Professional Modifier Low / Median / High Price $6,816.00 / $6,816.00 / $6,816.00	Professional		$6,816.00	$6,816.00	$6,816.00
Security Health Facility/Professional Professional Modifier Low / Median / High Price $17,472.00 / $17,472.00 / $17,472.00	Professional		$17,472.00	$17,472.00	$17,472.00
United Facility/Professional Professional Modifier Low / Median / High Price $1,440.00 / $1,920.00 / $5,956.48	Professional		$1,440.00	$1,920.00	$5,956.48