Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $1,539.24 / $1,539.24 / $1,539.24	Facility		$1,539.24	$1,539.24	$1,539.24
Aetna Facility/Professional Professional Modifier Low / Median / High Price $1,494.41 / $1,539.24 / $1,643.85	Professional		$1,494.41	$1,539.24	$1,643.85
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $1,494.41 / $1,494.41 / $2,241.61	Professional		$1,494.41	$1,494.41	$2,241.61
CareSource Facility/Professional Facility Modifier Low / Median / High Price $2,045.98 / $2,391.06 / $3,676.25	Facility		$2,045.98	$2,391.06	$3,676.25
Cigna Facility/Professional Facility Modifier Low / Median / High Price $2,119.62 / $3,877.61 / $5,495.92	Facility		$2,119.62	$3,877.61	$5,495.92
Cigna Facility/Professional Professional Modifier Low / Median / High Price $1,494.41 / $1,903.17 / $2,670.78	Professional		$1,494.41	$1,903.17	$2,670.78
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $1,426.17 / $1,539.24 / $2,293.46	Facility		$1,426.17	$1,539.24	$2,293.46
Medica Facility/Professional Facility Modifier Low / Median / High Price $1,426.17 / $1,557.67 / $2,406.17	Facility		$1,426.17	$1,557.67	$2,406.17
Medica Facility/Professional Professional Modifier Low / Median / High Price $1,542.24 / $1,542.24 / $3,238.70	Professional		$1,542.24	$1,542.24	$3,238.70
Molina Facility/Professional Professional Modifier Low / Median / High Price $50.00 / $70.00 / $3,646.21	Professional		$50.00	$70.00	$3,646.21
Prevea360 Facility/Professional Facility Modifier Low / Median / High Price $1,426.17 / $1,539.24 / $2,293.46	Facility		$1,426.17	$1,539.24	$2,293.46
Quartz Facility/Professional Professional Modifier Low / Median / High Price $1,494.41 / $1,830.76 / $3,918.82	Professional		$1,494.41	$1,830.76	$3,918.82
Quartz Facility/Professional Facility Modifier Low / Median / High Price $1,494.35 / $2,406.17 / $7,066.85	Facility		$1,494.35	$2,406.17	$7,066.85
Quartz Facility/Professional Professional Modifier Low / Median / High Price $1,494.41 / $2,265.02 / $7,066.85	Professional		$1,494.41	$2,265.02	$7,066.85
Security Health Facility/Professional Professional Modifier Low / Median / High Price $1,494.05 / $2,098.15 / $2,355.07	Professional		$1,494.05	$2,098.15	$2,355.07
United Facility/Professional Professional Modifier Low / Median / High Price $1,494.41 / $1,494.41 / $1,942.73	Professional		$1,494.41	$1,494.41	$1,942.73