Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $1,015.52 / $1,269.41 / $1,887.18	Facility		$1,015.52	$1,269.41	$1,887.18
Aetna Facility/Professional Professional Modifier Low / Median / High Price $651.63 / $803.96 / $1,286.33	Professional		$651.63	$803.96	$1,286.33
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $1,819.48 / $2,200.30 / $2,327.23	Facility		$1,819.48	$2,200.30	$2,327.23
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $846.27 / $846.27 / $3,638.96	Professional		$846.27	$846.27	$3,638.96
CareSource Facility/Professional Facility Modifier Low / Median / High Price $846.27 / $1,256.93 / $2,240.57	Facility		$846.27	$1,256.93	$2,240.57
CareSource Facility/Professional Professional Modifier Low / Median / High Price $846.27 / $888.58 / $1,094.11	Professional		$846.27	$888.58	$1,094.11
Cigna Facility/Professional Facility Modifier Low / Median / High Price $2,329.40 / $2,722.08 / $4,175.74	Facility		$2,329.40	$2,722.08	$4,175.74
Cigna Facility/Professional Professional Modifier Low / Median / High Price $972.20 / $2,278.84 / $2,589.59	Professional		$972.20	$2,278.84	$2,589.59
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $651.63 / $1,015.52 / $2,961.95	Facility		$651.63	$1,015.52	$2,961.95
Medica Facility/Professional Facility Modifier Low / Median / High Price $761.64 / $1,015.52 / $2,961.95	Facility		$761.64	$1,015.52	$2,961.95
Medica Facility/Professional Professional Modifier Low / Median / High Price $423.14 / $507.76 / $2,609.77	Professional		$423.14	$507.76	$2,609.77
Molina Facility/Professional Professional Modifier Low / Median / High Price $50.00 / $70.00 / $423.14	Professional		$50.00	$70.00	$423.14
Prevea360 Facility/Professional Facility Modifier Low / Median / High Price $651.63 / $1,015.52 / $2,961.95	Facility		$651.63	$1,015.52	$2,961.95
Quartz Facility/Professional Professional Modifier Low / Median / High Price $1,609.26 / $2,063.50 / $2,829.99	Professional		$1,609.26	$2,063.50	$2,829.99
Quartz Facility/Professional Facility Modifier Low / Median / High Price $4,614.88 / $4,614.88 / $4,614.88	Facility		$4,614.88	$4,614.88	$4,614.88
Quartz Facility/Professional Professional Modifier Low / Median / High Price $1,227.08 / $4,231.35 / $4,231.35	Professional		$1,227.08	$4,231.35	$4,231.35
Security Health Facility/Professional Professional Modifier Low / Median / High Price $846.27 / $846.27 / $1,802.17	Professional		$846.27	$846.27	$1,802.17
Security Health Facility/Professional Professional Modifier Low / Median / High Price $846.27 / $846.27 / $4,620.63	Professional		$846.27	$846.27	$4,620.63
United Facility/Professional Professional Modifier Low / Median / High Price $423.14 / $507.76 / $1,777.17	Professional		$423.14	$507.76	$1,777.17