Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $1,371.00 / $2,038.22 / $2,038.22	Facility		$1,371.00	$2,038.22	$2,038.22
Aetna Facility/Professional Professional Modifier Low / Median / High Price $1,389.28 / $5,877.02 / $5,877.02	Professional		$1,389.28	$5,877.02	$5,877.02
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $846.27 / $846.27 / $3,914.85	Professional		$846.27	$846.27	$3,914.85
CareSource Facility/Professional Facility Modifier Low / Median / High Price $2,233.73 / $2,233.73 / $2,321.56	Facility		$2,233.73	$2,233.73	$2,321.56
Cigna Facility/Professional Facility Modifier Low / Median / High Price $2,515.03 / $2,939.01 / $4,508.51	Facility		$2,515.03	$2,939.01	$4,508.51
Cigna Facility/Professional Professional Modifier Low / Median / High Price $1,050.26 / $2,461.21 / $2,796.84	Professional		$1,050.26	$2,461.21	$2,796.84
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $1,005.40 / $1,599.50 / $3,199.00	Facility		$1,005.40	$1,599.50	$3,199.00
Medica Facility/Professional Facility Modifier Low / Median / High Price $1,005.40 / $1,233.90 / $3,199.00	Facility		$1,005.40	$1,233.90	$3,199.00
Medica Facility/Professional Professional Modifier Low / Median / High Price $457.00 / $548.40 / $2,818.64	Professional		$457.00	$548.40	$2,818.64
Molina Facility/Professional Professional Modifier Low / Median / High Price $50.00 / $70.00 / $2,522.64	Professional		$50.00	$70.00	$2,522.64
Prevea360 Facility/Professional Facility Modifier Low / Median / High Price $1,005.40 / $1,599.50 / $3,199.00	Facility		$1,005.40	$1,599.50	$3,199.00
Quartz Facility/Professional Professional Modifier Low / Median / High Price $1,642.47 / $2,179.69 / $3,057.17	Professional		$1,642.47	$2,179.69	$3,057.17
Quartz Facility/Professional Facility Modifier Low / Median / High Price $1,828.00 / $4,341.50 / $4,341.50	Facility		$1,828.00	$4,341.50	$4,341.50
Quartz Facility/Professional Professional Modifier Low / Median / High Price $1,325.30 / $4,570.00 / $4,570.00	Professional		$1,325.30	$4,570.00	$4,570.00
Security Health Facility/Professional Professional Modifier Low / Median / High Price $1,946.40 / $1,946.40 / $1,946.40	Professional		$1,946.40	$1,946.40	$1,946.40
Security Health Facility/Professional Professional Modifier Low / Median / High Price $2,656.28 / $4,990.43 / $4,990.43	Professional		$2,656.28	$4,990.43	$4,990.43
United Facility/Professional Professional Modifier Low / Median / High Price $397.32 / $548.40 / $1,701.32	Professional		$397.32	$548.40	$1,701.32