Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $453.69 / $2,760.00 / $4,460.00	Facility		$453.69	$2,760.00	$4,460.00
Aetna Facility/Professional Professional Modifier Low / Median / High Price $1,540.00 / $1,900.00 / $3,040.00	Professional		$1,540.00	$1,900.00	$3,040.00
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $4,300.00 / $5,200.00 / $5,500.00	Facility		$4,300.00	$5,200.00	$5,500.00
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $964.59 / $2,000.00 / $8,566.42	Professional		$964.59	$2,000.00	$8,566.42
CareSource Facility/Professional Facility Modifier Low / Median / High Price $2,000.00 / $2,970.52 / $5,295.15	Facility		$2,000.00	$2,970.52	$5,295.15
CareSource Facility/Professional Professional Modifier Low / Median / High Price $2,000.00 / $2,100.00 / $2,585.98	Professional		$2,000.00	$2,100.00	$2,585.98
Cigna Facility/Professional Facility Modifier Low / Median / High Price $5,504.04 / $6,431.91 / $9,866.70	Facility		$5,504.04	$6,431.91	$9,866.70
Cigna Facility/Professional Professional Modifier Low / Median / High Price $2,298.35 / $5,385.60 / $6,120.00	Professional		$2,298.35	$5,385.60	$6,120.00
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $1,540.00 / $2,400.00 / $7,000.00	Facility		$1,540.00	$2,400.00	$7,000.00
Medica Facility/Professional Facility Modifier Low / Median / High Price $1,800.00 / $2,400.00 / $7,000.00	Facility		$1,800.00	$2,400.00	$7,000.00
Medica Facility/Professional Professional Modifier Low / Median / High Price $982.80 / $1,200.00 / $6,167.70	Professional		$982.80	$1,200.00	$6,167.70
Molina Facility/Professional Professional Modifier Low / Median / High Price $50.00 / $70.00 / $1,000.00	Professional		$50.00	$70.00	$1,000.00
Prevea360 Facility/Professional Facility Modifier Low / Median / High Price $1,540.00 / $2,400.00 / $7,000.00	Facility		$1,540.00	$2,400.00	$7,000.00
Quartz Facility/Professional Professional Modifier Low / Median / High Price $3,803.08 / $4,877.14 / $6,688.77	Professional		$3,803.08	$4,877.14	$6,688.77
Quartz Facility/Professional Facility Modifier Low / Median / High Price $4,631.74 / $9,500.00 / $9,500.00	Facility		$4,631.74	$9,500.00	$9,500.00
Quartz Facility/Professional Professional Modifier Low / Median / High Price $2,900.00 / $10,000.00 / $10,000.00	Professional		$2,900.00	$10,000.00	$10,000.00
Security Health Facility/Professional Professional Modifier Low / Median / High Price $2,000.00 / $2,000.00 / $4,259.09	Professional		$2,000.00	$2,000.00	$4,259.09
Security Health Facility/Professional Professional Modifier Low / Median / High Price $2,000.00 / $2,000.00 / $10,920.00	Professional		$2,000.00	$2,000.00	$10,920.00
United Facility/Professional Professional Modifier Low / Median / High Price $840.00 / $1,200.00 / $3,722.80	Professional		$840.00	$1,200.00	$3,722.80