Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $1,603.31 / $1,603.31 / $1,603.31	Facility		$1,603.31	$1,603.31	$1,603.31
Aetna Facility/Professional Professional Modifier Low / Median / High Price $1,028.79 / $1,269.29 / $1,603.31	Professional		$1,028.79	$1,269.29	$1,603.31
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $699.20 / $2,267.92 / $6,680.45	Professional		$699.20	$2,267.92	$6,680.45
CareSource Facility/Professional Facility Modifier Low / Median / High Price $2,033.26 / $2,033.26 / $2,033.26	Facility		$2,033.26	$2,033.26	$2,033.26
Cigna Facility/Professional Facility Modifier Low / Median / High Price $3,676.57 / $4,296.35 / $6,590.73	Facility		$3,676.57	$4,296.35	$6,590.73
Cigna Facility/Professional Professional Modifier Low / Median / High Price $1,581.17 / $3,597.83 / $4,088.44	Professional		$1,581.17	$3,597.83	$4,088.44
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $1,028.79 / $1,603.31 / $4,676.32	Facility		$1,028.79	$1,603.31	$4,676.32
Medica Facility/Professional Facility Modifier Low / Median / High Price $1,028.79 / $1,603.31 / $4,676.32	Facility		$1,028.79	$1,603.31	$4,676.32
Medica Facility/Professional Professional Modifier Low / Median / High Price $668.05 / $801.65 / $4,120.30	Professional		$668.05	$801.65	$4,120.30
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 $1,028.79 / $1,603.31 / $4,676.32	Facility		$1,028.79	$1,603.31	$4,676.32
Quartz Facility/Professional Professional Modifier Low / Median / High Price $2,230.73 / $3,186.24 / $4,468.92	Professional		$2,230.73	$3,186.24	$4,468.92
Quartz Facility/Professional Facility Modifier Low / Median / High Price $2,672.18 / $6,346.43 / $6,346.43	Facility		$2,672.18	$6,346.43	$6,346.43
Quartz Facility/Professional Professional Modifier Low / Median / High Price $5,344.36 / $5,344.36 / $6,653.73	Professional		$5,344.36	$5,344.36	$6,653.73
Security Health Facility/Professional Professional Modifier Low / Median / High Price $2,845.87 / $2,845.87 / $2,845.87	Professional		$2,845.87	$2,845.87	$2,845.87
Security Health Facility/Professional Professional Modifier Low / Median / High Price $7,295.05 / $7,295.05 / $7,295.05	Professional		$7,295.05	$7,295.05	$7,295.05
United Facility/Professional Professional Modifier Low / Median / High Price $668.05 / $801.65 / $2,487.00	Professional		$668.05	$801.65	$2,487.00