Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $2,641.95 / $2,641.95 / $2,641.95	Facility		$2,641.95	$2,641.95	$2,641.95
Aetna Facility/Professional Professional Modifier Low / Median / High Price $1,805.33 / $2,069.53 / $2,641.95	Professional		$1,805.33	$2,069.53	$2,641.95
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $12.34 / $12.34 / $8,806.48	Professional		$12.34	$12.34	$8,806.48
CareSource Facility/Professional Facility Modifier Low / Median / High Price $2,201.62 / $2,201.62 / $3,349.88	Facility		$2,201.62	$2,201.62	$3,349.88
Cigna Facility/Professional Facility Modifier Low / Median / High Price $6,059.13 / $7,080.57 / $10,861.78	Facility		$6,059.13	$7,080.57	$10,861.78
Cigna Facility/Professional Professional Modifier Low / Median / High Price $2,529.63 / $5,928.53 / $6,736.96	Professional		$2,529.63	$5,928.53	$6,736.96
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $1,320.97 / $2,201.62 / $4,028.97	Facility		$1,320.97	$2,201.62	$4,028.97
Medica Facility/Professional Facility Modifier Low / Median / High Price $1,320.97 / $2,641.94 / $10,457.70	Facility		$1,320.97	$2,641.94	$10,457.70
Medica Facility/Professional Professional Modifier Low / Median / High Price $1,276.94 / $2,201.62 / $4,623.39	Professional		$1,276.94	$2,201.62	$4,623.39
Molina Facility/Professional Professional Modifier Low / Median / High Price $85.00 / $85.00 / $1,100.81	Professional		$85.00	$85.00	$1,100.81
Prevea360 Facility/Professional Facility Modifier Low / Median / High Price $1,320.97 / $2,201.62 / $4,028.97	Facility		$1,320.97	$2,201.62	$4,028.97
Quartz Facility/Professional Professional Modifier Low / Median / High Price $2,586.28 / $5,249.47 / $7,486.60	Professional		$2,586.28	$5,249.47	$7,486.60
Quartz Facility/Professional Facility Modifier Low / Median / High Price $4,403.24 / $4,403.24 / $10,457.70	Facility		$4,403.24	$4,403.24	$10,457.70
Security Health Facility/Professional Professional Modifier Low / Median / High Price $4,689.45 / $4,689.45 / $4,689.45	Professional		$4,689.45	$4,689.45	$4,689.45
Security Health Facility/Professional Professional Modifier Low / Median / High Price $12,020.85 / $12,020.85 / $12,020.85	Professional		$12,020.85	$12,020.85	$12,020.85
United Facility/Professional Professional Modifier Low / Median / High Price $1,276.94 / $1,761.30 / $5,838.89	Professional		$1,276.94	$1,761.30	$5,838.89