Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $1,638.26 / $1,638.26 / $1,638.26	Facility		$1,638.26	$1,638.26	$1,638.26
Aetna Facility/Professional Professional Modifier Low / Median / High Price $1,590.54 / $1,638.26 / $1,749.59	Professional		$1,590.54	$1,638.26	$1,749.59
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $1,590.54 / $1,590.54 / $2,385.81	Professional		$1,590.54	$1,590.54	$2,385.81
CareSource Facility/Professional Facility Modifier Low / Median / High Price $2,177.59 / $2,528.96 / $2,544.86	Facility		$2,177.59	$2,528.96	$2,544.86
Cigna Facility/Professional Facility Modifier Low / Median / High Price $2,483.83 / $4,543.89 / $6,440.28	Facility		$2,483.83	$4,543.89	$6,440.28
Cigna Facility/Professional Professional Modifier Low / Median / High Price $215.68 / $1,590.54 / $2,363.67	Professional		$215.68	$1,590.54	$2,363.67
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $1,590.54 / $1,653.82 / $2,506.54	Facility		$1,590.54	$1,653.82	$2,506.54
Medica Facility/Professional Facility Modifier Low / Median / High Price $1,653.82 / $1,703.43 / $2,606.25	Facility		$1,653.82	$1,703.43	$2,606.25
Medica Facility/Professional Professional Modifier Low / Median / High Price $1,653.82 / $1,653.82 / $3,473.02	Professional		$1,653.82	$1,653.82	$3,473.02
Molina Facility/Professional Professional Modifier Low / Median / High Price $50.00 / $58.40 / $85.00	Professional		$50.00	$58.40	$85.00
Prevea360 Facility/Professional Facility Modifier Low / Median / High Price $1,590.54 / $1,653.82 / $2,506.54	Facility		$1,590.54	$1,653.82	$2,506.54
Quartz Facility/Professional Professional Modifier Low / Median / High Price $282.86 / $1,590.54 / $2,475.84	Professional		$282.86	$1,590.54	$2,475.84
Quartz Facility/Professional Facility Modifier Low / Median / High Price $1,853.66 / $2,550.00 / $11,250.00	Facility		$1,853.66	$2,550.00	$11,250.00
Quartz Facility/Professional Professional Modifier Low / Median / High Price $1,590.54 / $3,180.00 / $11,400.00	Professional		$1,590.54	$3,180.00	$11,400.00
Security Health Facility/Professional Professional Modifier Low / Median / High Price $2,233.12 / $2,233.12 / $2,233.12	Professional		$2,233.12	$2,233.12	$2,233.12
United Facility/Professional Professional Modifier Low / Median / High Price $1,590.54 / $1,590.54 / $2,067.69	Professional		$1,590.54	$1,590.54	$2,067.69