Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $1,950.00 / $2,437.50 / $3,623.75	Facility		$1,950.00	$2,437.50	$3,623.75
Aetna Facility/Professional Professional Modifier Low / Median / High Price $1,251.25 / $1,527.50 / $1,950.00	Professional		$1,251.25	$1,527.50	$1,950.00
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $3,493.75 / $4,225.00 / $4,468.75	Facility		$3,493.75	$4,225.00	$4,468.75
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $650.00 / $1,121.25 / $6,960.22	Professional		$650.00	$1,121.25	$6,960.22
CareSource Facility/Professional Facility Modifier Low / Median / High Price $1,222.81 / $3,971.35 / $4,127.50	Facility		$1,222.81	$3,971.35	$4,127.50
Cigna Facility/Professional Facility Modifier Low / Median / High Price $4,472.26 / $5,226.18 / $8,017.11	Facility		$4,472.26	$5,226.18	$8,017.11
Cigna Facility/Professional Professional Modifier Low / Median / High Price $1,867.59 / $4,375.80 / $4,972.50	Professional		$1,867.59	$4,375.80	$4,972.50
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $975.00 / $1,462.50 / $3,194.81	Facility		$975.00	$1,462.50	$3,194.81
Medica Facility/Professional Facility Modifier Low / Median / High Price $975.00 / $1,527.50 / $7,718.75	Facility		$975.00	$1,527.50	$7,718.75
Medica Facility/Professional Professional Modifier Low / Median / High Price $812.50 / $1,300.00 / $4,501.25	Professional		$812.50	$1,300.00	$4,501.25
Molina Facility/Professional Professional Modifier Low / Median / High Price $55.00 / $85.00 / $1,625.00	Professional		$55.00	$85.00	$1,625.00
Prevea360 Facility/Professional Facility Modifier Low / Median / High Price $975.00 / $1,462.50 / $3,194.81	Facility		$975.00	$1,462.50	$3,194.81
Quartz Facility/Professional Professional Modifier Low / Median / High Price $2,712.96 / $3,875.01 / $5,434.96	Professional		$2,712.96	$3,875.01	$5,434.96
Quartz Facility/Professional Facility Modifier Low / Median / High Price $861.25 / $3,250.00 / $7,718.75	Facility		$861.25	$3,250.00	$7,718.75
Quartz Facility/Professional Professional Modifier Low / Median / High Price $861.25 / $8,125.00 / $8,125.00	Professional		$861.25	$8,125.00	$8,125.00
Security Health Facility/Professional Professional Modifier Low / Median / High Price $1,625.00 / $1,625.00 / $3,460.51	Professional		$1,625.00	$1,625.00	$3,460.51
Security Health Facility/Professional Professional Modifier Low / Median / High Price $1,625.00 / $8,872.50 / $8,872.50	Professional		$1,625.00	$8,872.50	$8,872.50
United Facility/Professional Facility Modifier Low / Median / High Price $1,625.00 / $1,625.00 / $1,625.00	Facility		$1,625.00	$1,625.00	$1,625.00
United Facility/Professional Professional Modifier Low / Median / High Price $812.50 / $975.00 / $3,024.78	Professional		$812.50	$975.00	$3,024.78