Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $4,125.58 / $4,125.58 / $4,125.58	Facility		$4,125.58	$4,125.58	$4,125.58
Aetna Facility/Professional Professional Modifier Low / Median / High Price $2,647.25 / $3,266.08 / $4,125.58	Professional		$2,647.25	$3,266.08	$4,125.58
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $325.33 / $5,535.15 / $17,189.90	Professional		$325.33	$5,535.15	$17,189.90
CareSource Facility/Professional Facility Modifier Low / Median / High Price $5,231.53 / $5,231.53 / $5,231.53	Facility		$5,231.53	$5,231.53	$5,231.53
Cigna Facility/Professional Facility Modifier Low / Median / High Price $9,461.76 / $11,056.82 / $16,961.43	Facility		$9,461.76	$11,056.82	$16,961.43
Cigna Facility/Professional Professional Modifier Low / Median / High Price $4,068.86 / $9,257.79 / $10,520.23	Professional		$4,068.86	$9,257.79	$10,520.23
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $2,647.25 / $4,125.58 / $12,032.93	Facility		$2,647.25	$4,125.58	$12,032.93
Medica Facility/Professional Facility Modifier Low / Median / High Price $2,647.25 / $4,125.58 / $12,032.93	Facility		$2,647.25	$4,125.58	$12,032.93
Medica Facility/Professional Professional Modifier Low / Median / High Price $1,718.99 / $2,062.79 / $10,602.21	Professional		$1,718.99	$2,062.79	$10,602.21
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 $2,647.25 / $4,125.58 / $12,032.93	Facility		$2,647.25	$4,125.58	$12,032.93
Quartz Facility/Professional Professional Modifier Low / Median / High Price $5,739.66 / $8,198.15 / $11,498.45	Professional		$5,739.66	$8,198.15	$11,498.45
Quartz Facility/Professional Facility Modifier Low / Median / High Price $6,875.96 / $16,330.41 / $16,330.41	Facility		$6,875.96	$16,330.41	$16,330.41
Quartz Facility/Professional Professional Modifier Low / Median / High Price $13,751.92 / $13,751.92 / $17,121.14	Professional		$13,751.92	$13,751.92	$17,121.14
Security Health Facility/Professional Professional Modifier Low / Median / High Price $7,322.90 / $7,322.90 / $7,322.90	Professional		$7,322.90	$7,322.90	$7,322.90
Security Health Facility/Professional Professional Modifier Low / Median / High Price $18,771.37 / $18,771.37 / $18,771.37	Professional		$18,771.37	$18,771.37	$18,771.37
United Facility/Professional Professional Modifier Low / Median / High Price $1,494.49 / $2,062.79 / $7,219.76	Professional		$1,494.49	$2,062.79	$7,219.76