Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $4,647.60 / $4,647.60 / $4,647.60	Facility		$4,647.60	$4,647.60	$4,647.60
Aetna Facility/Professional Professional Modifier Low / Median / High Price $2,982.21 / $3,640.62 / $4,647.60	Professional		$2,982.21	$3,640.62	$4,647.60
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $1,148.40 / $1,148.40 / $15,492.00	Professional		$1,148.40	$1,148.40	$15,492.00
CareSource Facility/Professional Facility Modifier Low / Median / High Price $5,893.03 / $5,893.03 / $5,893.03	Facility		$5,893.03	$5,893.03	$5,893.03
Cigna Facility/Professional Facility Modifier Low / Median / High Price $10,658.45 / $12,455.24 / $19,106.66	Facility		$10,658.45	$12,455.24	$19,106.66
Cigna Facility/Professional Professional Modifier Low / Median / High Price $4,584.00 / $10,429.20 / $11,851.38	Professional		$4,584.00	$10,429.20	$11,851.38
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $2,982.21 / $4,647.60 / $13,555.50	Facility		$2,982.21	$4,647.60	$13,555.50
Medica Facility/Professional Facility Modifier Low / Median / High Price $2,982.21 / $4,647.60 / $13,555.50	Facility		$2,982.21	$4,647.60	$13,555.50
Medica Facility/Professional Professional Modifier Low / Median / High Price $1,936.50 / $2,323.80 / $11,943.75	Professional		$1,936.50	$2,323.80	$11,943.75
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 $2,982.21 / $4,647.60 / $13,555.50	Facility		$2,982.21	$4,647.60	$13,555.50
Quartz Facility/Professional Professional Modifier Low / Median / High Price $6,465.42 / $9,234.77 / $12,952.39	Professional		$6,465.42	$9,234.77	$12,952.39
Quartz Facility/Professional Facility Modifier Low / Median / High Price $7,746.00 / $18,396.75 / $18,396.75	Facility		$7,746.00	$18,396.75	$18,396.75
Quartz Facility/Professional Professional Modifier Low / Median / High Price $15,492.00 / $15,492.00 / $19,287.54	Professional		$15,492.00	$15,492.00	$19,287.54
Security Health Facility/Professional Professional Modifier Low / Median / High Price $8,249.49 / $8,249.49 / $8,249.49	Professional		$8,249.49	$8,249.49	$8,249.49
Security Health Facility/Professional Professional Modifier Low / Median / High Price $21,146.58 / $21,146.58 / $21,146.58	Professional		$21,146.58	$21,146.58	$21,146.58
United Facility/Professional Professional Modifier Low / Median / High Price $1,683.59 / $2,323.80 / $7,209.20	Professional		$1,683.59	$2,323.80	$7,209.20