Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $2,130.53 / $2,130.53 / $2,130.53	Facility		$2,130.53	$2,130.53	$2,130.53
Aetna Facility/Professional Professional Modifier Low / Median / High Price $2,068.46 / $2,130.53 / $2,275.32	Professional		$2,068.46	$2,130.53	$2,275.32
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $1,861.62 / $2,068.46 / $3,102.70	Professional		$1,861.62	$2,068.46	$3,102.70
CareSource Facility/Professional Facility Modifier Low / Median / High Price $2,831.93 / $3,288.87 / $3,309.55	Facility		$2,831.93	$3,288.87	$3,309.55
Cigna Facility/Professional Facility Modifier Low / Median / High Price $235.60 / $431.01 / $741.37	Facility		$235.60	$431.01	$741.37
Cigna Facility/Professional Professional Modifier Low / Median / High Price $184.74 / $312.02 / $2,068.46	Professional		$184.74	$312.02	$2,068.46
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $2,068.46 / $2,151.21 / $3,259.71	Facility		$2,068.46	$2,151.21	$3,259.71
Medica Facility/Professional Facility Modifier Low / Median / High Price $2,220.57 / $2,287.19 / $3,499.40	Facility		$2,220.57	$2,287.19	$3,499.40
Medica Facility/Professional Professional Modifier Low / Median / High Price $2,220.57 / $2,220.57 / $4,663.20	Professional		$2,220.57	$2,220.57	$4,663.20
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 $2,068.46 / $2,151.21 / $3,259.71	Facility		$2,068.46	$2,151.21	$3,259.71
Quartz Facility/Professional Professional Modifier Low / Median / High Price $405.81 / $2,068.46 / $2,378.73	Professional		$405.81	$2,068.46	$2,378.73
Quartz Facility/Professional Facility Modifier Low / Median / High Price $2,825.40 / $3,157.80 / $4,986.00	Facility		$2,825.40	$3,157.80	$4,986.00
Quartz Facility/Professional Professional Modifier Low / Median / High Price $2,068.46 / $3,523.44 / $11,634.00	Professional		$2,068.46	$3,523.44	$11,634.00
Security Health Facility/Professional Professional Modifier Low / Median / High Price $2,904.13 / $2,904.13 / $2,904.13	Professional		$2,904.13	$2,904.13	$2,904.13
United Facility/Professional Professional Modifier Low / Median / High Price $2,068.46 / $2,068.46 / $2,689.01	Professional		$2,068.46	$2,068.46	$2,689.01