Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $450.00 / $450.00 / $450.00	Facility		$450.00	$450.00	$450.00
Aetna Facility/Professional Professional Modifier Low / Median / High Price $450.00 / $450.00 / $450.00	Professional		$450.00	$450.00	$450.00
CareSource Facility/Professional Facility Modifier Low / Median / High Price $428.85 / $587.13 / $686.16	Facility		$428.85	$587.13	$686.16
Cigna Facility/Professional Facility Modifier Low / Median / High Price $441.00 / $454.23 / $1,263.64	Facility		$441.00	$454.23	$1,263.64
Cigna Facility/Professional Professional Modifier Low / Median / High Price $441.00 / $441.90 / $1,146.90	Professional		$441.00	$441.90	$1,146.90
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $428.85 / $514.62 / $950.09	Facility		$428.85	$514.62	$950.09
Medica Facility/Professional Facility Modifier Low / Median / High Price $428.85 / $548.92 / $1,151.90	Facility		$428.85	$548.92	$1,151.90
Medica Facility/Professional Professional Modifier Low / Median / High Price $524.29 / $789.77 / $1,626.04	Professional		$524.29	$789.77	$1,626.04
Molina Facility/Professional Professional Modifier Low / Median / High Price $428.85 / $428.85 / $1,633.50	Professional		$428.85	$428.85	$1,633.50
Prevea360 Facility/Professional Facility Modifier Low / Median / High Price $428.85 / $514.62 / $950.09	Facility		$428.85	$514.62	$950.09
Quartz Facility/Professional Professional Modifier Low / Median / High Price $710.94 / $1,072.88 / $1,530.10	Professional		$710.94	$1,072.88	$1,530.10
Quartz Facility/Professional Facility Modifier Low / Median / High Price $2,384.42 / $2,384.42 / $2,384.42	Facility		$2,384.42	$2,384.42	$2,384.42
Quartz Facility/Professional Professional Modifier Low / Median / High Price $371.73 / $371.73 / $371.73	Professional		$371.73	$371.73	$371.73
Security Health Facility/Professional Facility Modifier Low / Median / High Price $540.00 / $540.00 / $540.00	Facility		$540.00	$540.00	$540.00
United Facility/Professional Professional Modifier Low / Median / High Price $524.29 / $680.08 / $1,626.04	Professional		$524.29	$680.08	$1,626.04