Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $1,370.47 / $1,370.47 / $1,370.47	Facility		$1,370.47	$1,370.47	$1,370.47
Aetna Facility/Professional Professional Modifier Low / Median / High Price $879.39 / $1,084.96 / $1,370.47	Professional		$879.39	$1,084.96	$1,370.47
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $1,142.06 / $1,882.12 / $6,109.06	Professional		$1,142.06	$1,882.12	$6,109.06
CareSource Facility/Professional Facility Modifier Low / Median / High Price $1,737.93 / $1,737.93 / $1,737.93	Facility		$1,737.93	$1,737.93	$1,737.93
Cigna Facility/Professional Facility Modifier Low / Median / High Price $3,143.11 / $3,672.97 / $5,634.43	Facility		$3,143.11	$3,672.97	$5,634.43
Cigna Facility/Professional Professional Modifier Low / Median / High Price $1,351.89 / $3,075.34 / $3,494.70	Professional		$1,351.89	$3,075.34	$3,494.70
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $879.39 / $1,370.47 / $3,997.21	Facility		$879.39	$1,370.47	$3,997.21
Medica Facility/Professional Facility Modifier Low / Median / High Price $879.39 / $1,370.47 / $3,997.21	Facility		$879.39	$1,370.47	$3,997.21
Medica Facility/Professional Professional Modifier Low / Median / High Price $571.03 / $685.24 / $3,521.94	Professional		$571.03	$685.24	$3,521.94
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 $879.39 / $1,370.47 / $3,997.21	Facility		$879.39	$1,370.47	$3,997.21
Quartz Facility/Professional Professional Modifier Low / Median / High Price $1,906.74 / $2,723.46 / $3,819.84	Professional		$1,906.74	$2,723.46	$3,819.84
Quartz Facility/Professional Facility Modifier Low / Median / High Price $2,284.12 / $5,424.79 / $5,424.79	Facility		$2,284.12	$5,424.79	$5,424.79
Quartz Facility/Professional Professional Modifier Low / Median / High Price $4,568.24 / $4,568.24 / $5,687.46	Professional		$4,568.24	$4,568.24	$5,687.46
Security Health Facility/Professional Professional Modifier Low / Median / High Price $2,432.59 / $2,432.59 / $2,432.59	Professional		$2,432.59	$2,432.59	$2,432.59
Security Health Facility/Professional Professional Modifier Low / Median / High Price $6,235.65 / $6,235.65 / $6,235.65	Professional		$6,235.65	$6,235.65	$6,235.65
United Facility/Professional Facility Modifier Low / Median / High Price $1,142.06 / $1,142.06 / $1,142.06	Facility		$1,142.06	$1,142.06	$1,142.06
United Facility/Professional Professional Modifier Low / Median / High Price $496.45 / $685.24 / $2,398.33	Professional		$496.45	$685.24	$2,398.33