Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $2,340.00 / $2,340.00 / $2,340.00	Facility		$2,340.00	$2,340.00	$2,340.00
Aetna Facility/Professional Professional Modifier Low / Median / High Price $1,501.50 / $1,852.50 / $2,340.00	Professional		$1,501.50	$1,852.50	$2,340.00
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $1,549.20 / $1,549.20 / $8,086.82	Professional		$1,549.20	$1,549.20	$8,086.82
CareSource Facility/Professional Facility Modifier Low / Median / High Price $2,966.94 / $2,966.94 / $2,966.94	Facility		$2,966.94	$2,966.94	$2,966.94
Cigna Facility/Professional Facility Modifier Low / Median / High Price $5,366.17 / $6,270.79 / $9,619.56	Facility		$5,366.17	$6,270.79	$9,619.56
Cigna Facility/Professional Professional Modifier Low / Median / High Price $2,307.73 / $5,250.96 / $5,967.00	Professional		$2,307.73	$5,250.96	$5,967.00
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $1,501.50 / $2,340.00 / $6,825.00	Facility		$1,501.50	$2,340.00	$6,825.00
Medica Facility/Professional Facility Modifier Low / Median / High Price $1,501.50 / $2,340.00 / $6,825.00	Facility		$1,501.50	$2,340.00	$6,825.00
Medica Facility/Professional Professional Modifier Low / Median / High Price $975.00 / $1,170.00 / $6,013.51	Professional		$975.00	$1,170.00	$6,013.51
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 $1,501.50 / $2,340.00 / $6,825.00	Facility		$1,501.50	$2,340.00	$6,825.00
Quartz Facility/Professional Professional Modifier Low / Median / High Price $3,255.12 / $4,649.39 / $6,521.09	Professional		$3,255.12	$4,649.39	$6,521.09
Quartz Facility/Professional Facility Modifier Low / Median / High Price $3,900.00 / $9,262.50 / $9,262.50	Facility		$3,900.00	$9,262.50	$9,262.50
Quartz Facility/Professional Professional Modifier Low / Median / High Price $7,800.00 / $7,800.00 / $9,711.00	Professional		$7,800.00	$7,800.00	$9,711.00
Security Health Facility/Professional Professional Modifier Low / Median / High Price $4,153.50 / $4,153.50 / $4,153.50	Professional		$4,153.50	$4,153.50	$4,153.50
Security Health Facility/Professional Professional Modifier Low / Median / High Price $10,647.00 / $10,647.00 / $10,647.00	Professional		$10,647.00	$10,647.00	$10,647.00
United Facility/Professional Facility Modifier Low / Median / High Price $2,340.00 / $2,340.00 / $2,340.00	Facility		$2,340.00	$2,340.00	$2,340.00
United Facility/Professional Professional Modifier Low / Median / High Price $847.67 / $1,170.00 / $4,095.00	Professional		$847.67	$1,170.00	$4,095.00