Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $1,214.63 / $1,214.63 / $6,736.96	Facility		$1,214.63	$1,214.63	$6,736.96
Aetna Facility/Professional Professional Modifier Low / Median / High Price $965.00 / $1,214.63 / $2,086.73	Professional		$965.00	$1,214.63	$2,086.73
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $1,214.63 / $1,214.63 / $1,217.06	Professional		$1,214.63	$1,214.63	$1,217.06
CareSource Facility/Professional Professional Modifier Low / Median / High Price $1,238.93 / $1,238.93 / $1,238.93	Professional		$1,238.93	$1,238.93	$1,238.93
Cigna Facility/Professional Facility Modifier Low / Median / High Price $1,238.93 / $2,755.02 / $3,938.12	Facility		$1,238.93	$2,755.02	$3,938.12
Cigna Facility/Professional Professional Modifier Low / Median / High Price $1,214.63 / $1,251.06 / $1,518.28	Professional		$1,214.63	$1,251.06	$1,518.28
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $1,214.63 / $1,457.56 / $1,518.29	Facility		$1,214.63	$1,457.56	$1,518.29
Medica Facility/Professional Facility Modifier Low / Median / High Price $1,214.63 / $1,821.95 / $5,203.28	Facility		$1,214.63	$1,821.95	$5,203.28
Medica Facility/Professional Professional Modifier Low / Median / High Price $910.97 / $1,214.63 / $1,579.02	Professional		$910.97	$1,214.63	$1,579.02
Molina Facility/Professional Professional Modifier Low / Median / High Price $50.00 / $65.00 / $3,218.39	Professional		$50.00	$65.00	$3,218.39
Prevea360 Facility/Professional Facility Modifier Low / Median / High Price $1,214.63 / $1,457.56 / $1,518.29	Facility		$1,214.63	$1,457.56	$1,518.29
Quartz Facility/Professional Professional Modifier Low / Median / High Price $1,272.00 / $1,272.00 / $1,272.00	Professional		$1,272.00	$1,272.00	$1,272.00
Quartz Facility/Professional Facility Modifier Low / Median / High Price $1,238.93 / $1,238.93 / $5,203.28	Facility		$1,238.93	$1,238.93	$5,203.28
Quartz Facility/Professional Professional Modifier Low / Median / High Price $1,238.93 / $1,238.93 / $1,238.93	Professional		$1,238.93	$1,238.93	$1,238.93
Security Health Facility/Professional Professional Modifier Low / Median / High Price $698.80 / $822.12 / $1,277.67	Professional		$698.80	$822.12	$1,277.67
United Facility/Professional Professional Modifier Low / Median / High Price $1,032.44 / $1,214.63 / $1,579.02	Professional		$1,032.44	$1,214.63	$1,579.02