Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $1,274.40 / $1,274.40 / $1,274.40	Facility		$1,274.40	$1,274.40	$1,274.40
Aetna Facility/Professional Professional Modifier Low / Median / High Price $1,237.28 / $1,274.40 / $1,361.01	Professional		$1,237.28	$1,274.40	$1,361.01
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $1,237.28 / $1,237.28 / $2,103.37	Professional		$1,237.28	$1,237.28	$2,103.37
CareSource Facility/Professional Facility Modifier Low / Median / High Price $1,693.95 / $1,979.65 / $1,979.65	Facility		$1,693.95	$1,979.65	$1,979.65
Cigna Facility/Professional Facility Modifier Low / Median / High Price $1,753.83 / $3,208.44 / $4,547.47	Facility		$1,753.83	$3,208.44	$4,547.47
Cigna Facility/Professional Professional Modifier Low / Median / High Price $1,108.19 / $1,344.89 / $2,593.28	Professional		$1,108.19	$1,344.89	$2,593.28
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $106.56 / $1,274.40 / $1,949.83	Facility		$106.56	$1,274.40	$1,949.83
Medica Facility/Professional Facility Modifier Low / Median / High Price $106.56 / $1,226.15 / $1,839.23	Facility		$106.56	$1,226.15	$1,839.23
Medica Facility/Professional Professional Modifier Low / Median / High Price $1,190.44 / $1,190.44 / $2,499.92	Professional		$1,190.44	$1,190.44	$2,499.92
Molina Facility/Professional Professional Modifier Low / Median / High Price $50.00 / $65.00 / $2,576.57	Professional		$50.00	$65.00	$2,576.57
Prevea360 Facility/Professional Facility Modifier Low / Median / High Price $106.56 / $1,274.40 / $1,949.83	Facility		$106.56	$1,274.40	$1,949.83
Quartz Facility/Professional Professional Modifier Low / Median / High Price $1,237.28 / $1,406.04 / $3,370.97	Professional		$1,237.28	$1,406.04	$3,370.97
Quartz Facility/Professional Facility Modifier Low / Median / High Price $1,055.97 / $1,428.00 / $5,119.78	Facility		$1,055.97	$1,428.00	$5,119.78
Quartz Facility/Professional Professional Modifier Low / Median / High Price $1,237.28 / $2,133.23 / $5,119.78	Professional		$1,237.28	$2,133.23	$5,119.78
Security Health Facility/Professional Professional Modifier Low / Median / High Price $1,737.14 / $1,737.14 / $1,737.14	Professional		$1,737.14	$1,737.14	$1,737.14
United Facility/Professional Professional Modifier Low / Median / High Price $1,113.55 / $1,237.28 / $1,679.60	Professional		$1,113.55	$1,237.28	$1,679.60