Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $2,106.00 / $2,106.00 / $2,106.00	Facility		$2,106.00	$2,106.00	$2,106.00
Aetna Facility/Professional Professional Modifier Low / Median / High Price $1,351.35 / $1,649.70 / $2,106.00	Professional		$1,351.35	$1,649.70	$2,106.00
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $423.14 / $423.14 / $7,159.08	Professional		$423.14	$423.14	$7,159.08
CareSource Facility/Professional Facility Modifier Low / Median / High Price $2,670.64 / $2,670.64 / $2,670.64	Facility		$2,670.64	$2,670.64	$2,670.64
Cigna Facility/Professional Facility Modifier Low / Median / High Price $4,830.00 / $5,644.24 / $8,658.41	Facility		$4,830.00	$5,644.24	$8,658.41
Cigna Facility/Professional Professional Modifier Low / Median / High Price $2,077.17 / $4,725.85 / $5,370.30	Professional		$2,077.17	$4,725.85	$5,370.30
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $1,351.35 / $2,106.00 / $6,142.50	Facility		$1,351.35	$2,106.00	$6,142.50
Medica Facility/Professional Facility Modifier Low / Median / High Price $1,351.35 / $2,106.00 / $6,142.50	Facility		$1,351.35	$2,106.00	$6,142.50
Medica Facility/Professional Professional Modifier Low / Median / High Price $877.50 / $1,053.00 / $5,412.16	Professional		$877.50	$1,053.00	$5,412.16
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 $1,351.35 / $2,106.00 / $6,142.50	Facility		$1,351.35	$2,106.00	$6,142.50
Quartz Facility/Professional Professional Modifier Low / Median / High Price $2,930.04 / $4,185.07 / $5,869.85	Professional		$2,930.04	$4,185.07	$5,869.85
Quartz Facility/Professional Facility Modifier Low / Median / High Price $3,510.00 / $8,336.25 / $8,336.25	Facility		$3,510.00	$8,336.25	$8,336.25
Quartz Facility/Professional Professional Modifier Low / Median / High Price $7,020.00 / $7,020.00 / $8,739.90	Professional		$7,020.00	$7,020.00	$8,739.90
Security Health Facility/Professional Professional Modifier Low / Median / High Price $3,738.15 / $3,738.15 / $3,738.15	Professional		$3,738.15	$3,738.15	$3,738.15
Security Health Facility/Professional Professional Modifier Low / Median / High Price $9,582.29 / $9,582.29 / $9,582.29	Professional		$9,582.29	$9,582.29	$9,582.29
United Facility/Professional Facility Modifier Low / Median / High Price $1,404.00 / $1,404.00 / $3,808.35	Facility		$1,404.00	$1,404.00	$3,808.35
United Facility/Professional Professional Modifier Low / Median / High Price $737.10 / $1,053.00 / $3,685.50	Professional		$737.10	$1,053.00	$3,685.50