Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $1,080.00 / $1,350.00 / $2,007.00	Facility		$1,080.00	$1,350.00	$2,007.00
Aetna Facility/Professional Professional Modifier Low / Median / High Price $318.36 / $1,050.00 / $1,235.97	Professional		$318.36	$1,050.00	$1,235.97
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $1,935.00 / $2,340.00 / $2,475.00	Facility		$1,935.00	$2,340.00	$2,475.00
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $360.00 / $900.00 / $3,854.89	Professional		$360.00	$900.00	$3,854.89
CareSource Facility/Professional Facility Modifier Low / Median / High Price $2,199.52 / $2,199.52 / $2,286.00	Facility		$2,199.52	$2,199.52	$2,286.00
Cigna Facility/Professional Facility Modifier Low / Median / High Price $2,477.17 / $2,894.78 / $4,440.67	Facility		$2,477.17	$2,894.78	$4,440.67
Cigna Facility/Professional Professional Modifier Low / Median / High Price $1,034.15 / $2,423.52 / $2,754.00	Professional		$1,034.15	$2,423.52	$2,754.00
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $693.00 / $1,080.00 / $3,150.00	Facility		$693.00	$1,080.00	$3,150.00
Medica Facility/Professional Facility Modifier Low / Median / High Price $810.00 / $1,080.00 / $3,150.00	Facility		$810.00	$1,080.00	$3,150.00
Medica Facility/Professional Professional Modifier Low / Median / High Price $450.00 / $540.00 / $2,775.47	Professional		$450.00	$540.00	$2,775.47
Molina Facility/Professional Professional Modifier Low / Median / High Price $50.00 / $70.00 / $516.91	Professional		$50.00	$70.00	$516.91
Prevea360 Facility/Professional Facility Modifier Low / Median / High Price $693.00 / $1,080.00 / $3,150.00	Facility		$693.00	$1,080.00	$3,150.00
Quartz Facility/Professional Professional Modifier Low / Median / High Price $1,711.25 / $2,194.44 / $3,009.57	Professional		$1,711.25	$2,194.44	$3,009.57
Quartz Facility/Professional Facility Modifier Low / Median / High Price $1,800.00 / $4,275.00 / $4,275.00	Facility		$1,800.00	$4,275.00	$4,275.00
Quartz Facility/Professional Professional Modifier Low / Median / High Price $1,305.00 / $4,500.00 / $4,500.00	Professional		$1,305.00	$4,500.00	$4,500.00
Security Health Facility/Professional Professional Modifier Low / Median / High Price $1,916.59 / $1,916.59 / $1,916.59	Professional		$1,916.59	$1,916.59	$1,916.59
Security Health Facility/Professional Professional Modifier Low / Median / High Price $2,615.59 / $4,914.00 / $4,914.00	Professional		$2,615.59	$4,914.00	$4,914.00
United Facility/Professional Professional Modifier Low / Median / High Price $405.00 / $540.00 / $1,890.00	Professional		$405.00	$540.00	$1,890.00