Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $1,392.00 / $1,392.00 / $2,586.80	Facility		$1,392.00	$1,392.00	$2,586.80
Aetna Facility/Professional Professional Modifier Low / Median / High Price $893.20 / $1,102.00 / $1,763.20	Professional		$893.20	$1,102.00	$1,763.20
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $2,494.00 / $3,016.00 / $3,190.00	Facility		$2,494.00	$3,016.00	$3,190.00
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $464.00 / $584.64 / $4,968.52	Professional		$464.00	$584.64	$4,968.52
CareSource Facility/Professional Facility Modifier Low / Median / High Price $2,946.40 / $2,946.40 / $2,946.40	Facility		$2,946.40	$2,946.40	$2,946.40
Cigna Facility/Professional Facility Modifier Low / Median / High Price $3,192.67 / $3,730.89 / $5,723.27	Facility		$3,192.67	$3,730.89	$5,723.27
Cigna Facility/Professional Professional Modifier Low / Median / High Price $1,332.75 / $3,123.65 / $3,549.60	Professional		$1,332.75	$3,123.65	$3,549.60
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $893.20 / $1,392.00 / $4,060.00	Facility		$893.20	$1,392.00	$4,060.00
Medica Facility/Professional Facility Modifier Low / Median / High Price $893.20 / $1,392.00 / $4,060.00	Facility		$893.20	$1,392.00	$4,060.00
Medica Facility/Professional Professional Modifier Low / Median / High Price $580.00 / $696.00 / $3,577.27	Professional		$580.00	$696.00	$3,577.27
Molina Facility/Professional Professional Modifier Low / Median / High Price $50.00 / $70.00 / $928.00	Professional		$50.00	$70.00	$928.00
Prevea360 Facility/Professional Facility Modifier Low / Median / High Price $893.20 / $1,392.00 / $4,060.00	Facility		$893.20	$1,392.00	$4,060.00
Quartz Facility/Professional Professional Modifier Low / Median / High Price $2,084.17 / $2,765.88 / $3,879.33	Professional		$2,084.17	$2,765.88	$3,879.33
Quartz Facility/Professional Facility Modifier Low / Median / High Price $2,320.00 / $5,510.00 / $5,510.00	Facility		$2,320.00	$5,510.00	$5,510.00
Quartz Facility/Professional Professional Modifier Low / Median / High Price $1,682.00 / $5,800.00 / $5,800.00	Professional		$1,682.00	$5,800.00	$5,800.00
Security Health Facility/Professional Professional Modifier Low / Median / High Price $1,160.00 / $1,160.00 / $2,470.27	Professional		$1,160.00	$1,160.00	$2,470.27
Security Health Facility/Professional Professional Modifier Low / Median / High Price $1,160.00 / $3,722.08 / $6,333.60	Professional		$1,160.00	$3,722.08	$6,333.60
United Facility/Professional Facility Modifier Low / Median / High Price $1,392.00 / $1,392.00 / $1,392.00	Facility		$1,392.00	$1,392.00	$1,392.00
United Facility/Professional Professional Modifier Low / Median / High Price $580.00 / $742.75 / $3,178.98	Professional		$580.00	$742.75	$3,178.98