Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $900.00 / $900.00 / $900.00	Facility		$900.00	$900.00	$900.00
Aetna Facility/Professional Professional Modifier Low / Median / High Price $615.00 / $705.00 / $900.00	Professional		$615.00	$705.00	$900.00
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $336.26 / $336.26 / $3,000.00	Professional		$336.26	$336.26	$3,000.00
CareSource Facility/Professional Facility Modifier Low / Median / High Price $525.00 / $750.00 / $1,141.40	Facility		$525.00	$750.00	$1,141.40
Cigna Facility/Professional Facility Modifier Low / Median / High Price $2,063.56 / $2,411.44 / $3,699.21	Facility		$2,063.56	$2,411.44	$3,699.21
Cigna Facility/Professional Professional Modifier Low / Median / High Price $861.93 / $2,019.60 / $2,295.00	Professional		$861.93	$2,019.60	$2,295.00
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $450.00 / $615.00 / $900.00	Facility		$450.00	$615.00	$900.00
Medica Facility/Professional Facility Modifier Low / Median / High Price $450.00 / $675.00 / $3,562.50	Facility		$450.00	$675.00	$3,562.50
Medica Facility/Professional Professional Modifier Low / Median / High Price $435.00 / $750.00 / $1,575.00	Professional		$435.00	$750.00	$1,575.00
Molina Facility/Professional Professional Modifier Low / Median / High Price $85.00 / $85.00 / $85.00	Professional		$85.00	$85.00	$85.00
Prevea360 Facility/Professional Facility Modifier Low / Median / High Price $450.00 / $615.00 / $900.00	Facility		$450.00	$615.00	$900.00
Quartz Facility/Professional Professional Modifier Low / Median / High Price $881.22 / $1,788.64 / $2,550.90	Professional		$881.22	$1,788.64	$2,550.90
Quartz Facility/Professional Facility Modifier Low / Median / High Price $1,500.00 / $1,500.00 / $3,562.50	Facility		$1,500.00	$1,500.00	$3,562.50
Security Health Facility/Professional Professional Modifier Low / Median / High Price $1,597.50 / $1,597.50 / $1,597.50	Professional		$1,597.50	$1,597.50	$1,597.50
Security Health Facility/Professional Professional Modifier Low / Median / High Price $4,095.00 / $4,095.00 / $4,095.00	Professional		$4,095.00	$4,095.00	$4,095.00
United Facility/Professional Professional Modifier Low / Median / High Price $375.00 / $600.00 / $1,575.00	Professional		$375.00	$600.00	$1,575.00