Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $2,436.00 / $2,436.00 / $2,436.00	Facility		$2,436.00	$2,436.00	$2,436.00
Aetna Facility/Professional Professional Modifier Low / Median / High Price $1,563.10 / $1,908.20 / $2,436.00	Professional		$1,563.10	$1,908.20	$2,436.00
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $304.00 / $304.00 / $8,120.00	Professional		$304.00	$304.00	$8,120.00
CareSource Facility/Professional Facility Modifier Low / Median / High Price $3,089.00 / $3,089.00 / $3,089.00	Facility		$3,089.00	$3,089.00	$3,089.00
Cigna Facility/Professional Facility Modifier Low / Median / High Price $5,586.94 / $6,528.79 / $10,015.33	Facility		$5,586.94	$6,528.79	$10,015.33
Cigna Facility/Professional Professional Modifier Low / Median / High Price $2,402.60 / $5,466.38 / $6,211.80	Professional		$2,402.60	$5,466.38	$6,211.80
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $1,563.10 / $2,436.00 / $7,105.00	Facility		$1,563.10	$2,436.00	$7,105.00
Medica Facility/Professional Facility Modifier Low / Median / High Price $1,563.10 / $2,436.00 / $7,105.00	Facility		$1,563.10	$2,436.00	$7,105.00
Medica Facility/Professional Professional Modifier Low / Median / High Price $1,015.00 / $1,218.00 / $6,260.22	Professional		$1,015.00	$1,218.00	$6,260.22
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 $1,563.10 / $2,436.00 / $7,105.00	Facility		$1,563.10	$2,436.00	$7,105.00
Quartz Facility/Professional Professional Modifier Low / Median / High Price $3,389.04 / $4,840.68 / $6,789.38	Professional		$3,389.04	$4,840.68	$6,789.38
Quartz Facility/Professional Facility Modifier Low / Median / High Price $4,060.00 / $9,642.50 / $9,642.50	Facility		$4,060.00	$9,642.50	$9,642.50
Quartz Facility/Professional Professional Modifier Low / Median / High Price $8,120.00 / $8,120.00 / $10,109.40	Professional		$8,120.00	$8,120.00	$10,109.40
Security Health Facility/Professional Professional Modifier Low / Median / High Price $4,323.89 / $4,323.89 / $4,323.89	Professional		$4,323.89	$4,323.89	$4,323.89
Security Health Facility/Professional Professional Modifier Low / Median / High Price $11,083.80 / $11,083.80 / $11,083.80	Professional		$11,083.80	$11,083.80	$11,083.80
United Facility/Professional Facility Modifier Low / Median / High Price $2,030.00 / $2,030.00 / $2,030.00	Facility		$2,030.00	$2,030.00	$2,030.00
United Facility/Professional Professional Modifier Low / Median / High Price $913.50 / $1,218.00 / $3,778.64	Professional		$913.50	$1,218.00	$3,778.64