Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $1,100.00 / $1,213.00 / $1,213.00	Facility		$1,100.00	$1,213.00	$1,213.00
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $345.85 / $650.21 / $2,032.99	Professional		$345.85	$650.21	$2,032.99
CareSource Facility/Professional Facility Modifier Low / Median / High Price $307.55 / $322.93 / $430.57	Facility		$307.55	$322.93	$430.57
CareSource Facility/Professional Professional Modifier Low / Median / High Price $417.28 / $417.28 / $417.28	Professional		$417.28	$417.28	$417.28
Cigna Facility/Professional Facility Modifier Low / Median / High Price $1,828.37 / $2,136.60 / $3,277.60	Facility		$1,828.37	$2,136.60	$3,277.60
Cigna Facility/Professional Professional Modifier Low / Median / High Price $1,091.50 / $1,703.33 / $1,935.60	Professional		$1,091.50	$1,703.33	$1,935.60
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $328.74 / $513.79 / $655.87	Facility		$328.74	$513.79	$655.87
Medica Facility/Professional Facility Modifier Low / Median / High Price $384.84 / $536.07 / $2,101.38	Facility		$384.84	$536.07	$2,101.38
Medica Facility/Professional Professional Modifier Low / Median / High Price $408.06 / $874.80 / $2,349.37	Professional		$408.06	$874.80	$2,349.37
Molina Facility/Professional Professional Modifier Low / Median / High Price $50.00 / $70.00 / $1,147.01	Professional		$50.00	$70.00	$1,147.01
Prevea360 Facility/Professional Facility Modifier Low / Median / High Price $323.12 / $415.30 / $655.87	Facility		$323.12	$415.30	$655.87
Quartz Facility/Professional Professional Modifier Low / Median / High Price $677.95 / $822.72 / $1,184.43	Professional		$677.95	$822.72	$1,184.43
Quartz Facility/Professional Facility Modifier Low / Median / High Price $1,761.50 / $1,761.50 / $1,761.50	Facility		$1,761.50	$1,761.50	$1,761.50
Quartz Facility/Professional Professional Modifier Low / Median / High Price $1,525.37 / $1,749.60 / $2,349.37	Professional		$1,525.37	$1,749.60	$2,349.37
United Facility/Professional Facility Modifier Low / Median / High Price $1,479.13 / $1,479.13 / $1,907.30	Facility		$1,479.13	$1,479.13	$1,907.30
United Facility/Professional Professional Modifier Low / Median / High Price $384.84 / $832.21 / $1,964.14	Professional		$384.84	$832.21	$1,964.14