Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $1,076.40 / $1,076.40 / $1,076.40	Facility		$1,076.40	$1,076.40	$1,076.40
Aetna Facility/Professional Professional Modifier Low / Median / High Price $735.54 / $843.18 / $1,076.40	Professional		$735.54	$843.18	$1,076.40
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $547.16 / $1,515.93 / $4,153.10	Professional		$547.16	$1,515.93	$4,153.10
CareSource Facility/Professional Facility Modifier Low / Median / High Price $809.99 / $897.00 / $1,364.86	Facility		$809.99	$897.00	$1,364.86
Cigna Facility/Professional Facility Modifier Low / Median / High Price $2,468.17 / $2,884.25 / $4,424.51	Facility		$2,468.17	$2,884.25	$4,424.51
Cigna Facility/Professional Professional Modifier Low / Median / High Price $1,030.84 / $2,415.44 / $2,744.83	Professional		$1,030.84	$2,415.44	$2,744.83
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $538.20 / $735.54 / $1,076.40	Facility		$538.20	$735.54	$1,076.40
Medica Facility/Professional Facility Modifier Low / Median / High Price $538.20 / $807.30 / $4,260.75	Facility		$538.20	$807.30	$4,260.75
Medica Facility/Professional Professional Modifier Low / Median / High Price $520.26 / $897.00 / $1,883.70	Professional		$520.26	$897.00	$1,883.70
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 $538.20 / $735.54 / $1,076.40	Facility		$538.20	$735.54	$1,076.40
Quartz Facility/Professional Professional Modifier Low / Median / High Price $1,053.74 / $2,138.81 / $3,050.30	Professional		$1,053.74	$2,138.81	$3,050.30
Quartz Facility/Professional Facility Modifier Low / Median / High Price $1,794.00 / $1,794.00 / $4,260.75	Facility		$1,794.00	$1,794.00	$4,260.75
Security Health Facility/Professional Professional Modifier Low / Median / High Price $1,910.61 / $1,910.61 / $1,910.61	Professional		$1,910.61	$1,910.61	$1,910.61
Security Health Facility/Professional Professional Modifier Low / Median / High Price $4,897.62 / $4,897.62 / $4,897.62	Professional		$4,897.62	$4,897.62	$4,897.62
United Facility/Professional Professional Modifier Low / Median / High Price $448.50 / $717.60 / $1,669.68	Professional		$448.50	$717.60	$1,669.68