Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $2,019.83 / $2,019.83 / $2,019.83	Facility		$2,019.83	$2,019.83	$2,019.83
Aetna Facility/Professional Professional Modifier Low / Median / High Price $1,961.00 / $2,019.83 / $2,157.10	Professional		$1,961.00	$2,019.83	$2,157.10
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $1,961.00 / $1,961.00 / $3,137.60	Professional		$1,961.00	$1,961.00	$3,137.60
CareSource Facility/Professional Facility Modifier Low / Median / High Price $2,684.79 / $3,137.60 / $3,137.60	Facility		$2,684.79	$3,137.60	$3,137.60
Cigna Facility/Professional Facility Modifier Low / Median / High Price $2,695.40 / $4,930.93 / $6,988.84	Facility		$2,695.40	$4,930.93	$6,988.84
Cigna Facility/Professional Professional Modifier Low / Median / High Price $1,961.00 / $2,565.00 / $3,005.74	Professional		$1,961.00	$2,565.00	$3,005.74
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $1,961.00 / $2,019.83 / $3,090.34	Facility		$1,961.00	$2,019.83	$3,090.34
Medica Facility/Professional Facility Modifier Low / Median / High Price $1,961.00 / $2,019.83 / $3,090.34	Facility		$1,961.00	$2,019.83	$3,090.34
Medica Facility/Professional Professional Modifier Low / Median / High Price $1,961.00 / $1,961.00 / $4,118.10	Professional		$1,961.00	$1,961.00	$4,118.10
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 $1,961.00 / $2,019.83 / $3,090.34	Facility		$1,961.00	$2,019.83	$3,090.34
Quartz Facility/Professional Professional Modifier Low / Median / High Price $1,961.00 / $1,961.00 / $3,700.00	Professional		$1,961.00	$1,961.00	$3,700.00
Quartz Facility/Professional Facility Modifier Low / Median / High Price $1,961.00 / $2,040.00 / $6,562.50	Facility		$1,961.00	$2,040.00	$6,562.50
Quartz Facility/Professional Professional Modifier Low / Median / High Price $1,961.00 / $2,755.00 / $6,720.00	Professional		$1,961.00	$2,755.00	$6,720.00
Security Health Facility/Professional Professional Modifier Low / Median / High Price $2,753.24 / $2,753.24 / $2,753.24	Professional		$2,753.24	$2,753.24	$2,753.24
United Facility/Professional Professional Modifier Low / Median / High Price $1,961.00 / $1,961.00 / $2,400.63	Professional		$1,961.00	$1,961.00	$2,400.63