Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $2,490.96 / $2,490.96 / $2,490.96	Facility		$2,490.96	$2,490.96	$2,490.96
Aetna Facility/Professional Professional Modifier Low / Median / High Price $1,702.16 / $1,951.25 / $2,490.96	Professional		$1,702.16	$1,951.25	$2,490.96
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $12.34 / $12.34 / $8,303.20	Professional		$12.34	$12.34	$8,303.20
CareSource Facility/Professional Facility Modifier Low / Median / High Price $2,075.80 / $2,075.80 / $3,158.41	Facility		$2,075.80	$2,075.80	$3,158.41
Cigna Facility/Professional Facility Modifier Low / Median / High Price $5,712.20 / $6,675.16 / $10,239.86	Facility		$5,712.20	$6,675.16	$10,239.86
Cigna Facility/Professional Professional Modifier Low / Median / High Price $2,385.08 / $5,589.72 / $6,351.95	Professional		$2,385.08	$5,589.72	$6,351.95
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $1,245.48 / $2,075.80 / $3,798.72	Facility		$1,245.48	$2,075.80	$3,798.72
Medica Facility/Professional Facility Modifier Low / Median / High Price $1,245.48 / $2,490.96 / $9,860.04	Facility		$1,245.48	$2,490.96	$9,860.04
Medica Facility/Professional Professional Modifier Low / Median / High Price $1,203.96 / $2,075.80 / $4,359.18	Professional		$1,203.96	$2,075.80	$4,359.18
Molina Facility/Professional Professional Modifier Low / Median / High Price $85.00 / $85.00 / $1,037.90	Professional		$85.00	$85.00	$1,037.90
Prevea360 Facility/Professional Facility Modifier Low / Median / High Price $1,245.48 / $2,075.80 / $3,798.72	Facility		$1,245.48	$2,075.80	$3,798.72
Quartz Facility/Professional Professional Modifier Low / Median / High Price $2,438.46 / $4,949.43 / $7,058.70	Professional		$2,438.46	$4,949.43	$7,058.70
Quartz Facility/Professional Facility Modifier Low / Median / High Price $4,151.60 / $4,151.60 / $9,860.04	Facility		$4,151.60	$4,151.60	$9,860.04
Security Health Facility/Professional Professional Modifier Low / Median / High Price $4,421.45 / $4,421.45 / $4,421.45	Professional		$4,421.45	$4,421.45	$4,421.45
Security Health Facility/Professional Professional Modifier Low / Median / High Price $11,333.87 / $11,333.87 / $11,333.87	Professional		$11,333.87	$11,333.87	$11,333.87
United Facility/Professional Facility Modifier Low / Median / High Price $2,075.80 / $2,075.80 / $2,075.80	Facility		$2,075.80	$2,075.80	$2,075.80
United Facility/Professional Professional Modifier Low / Median / High Price $1,037.90 / $1,660.64 / $4,359.18	Professional		$1,037.90	$1,660.64	$4,359.18