Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $1,470.27 / $1,470.27 / $1,470.27	Facility		$1,470.27	$1,470.27	$1,470.27
Aetna Facility/Professional Professional Modifier Low / Median / High Price $1,427.45 / $1,470.27 / $1,570.20	Professional		$1,427.45	$1,470.27	$1,570.20
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $1,427.45 / $1,427.45 / $2,341.01	Professional		$1,427.45	$1,427.45	$2,341.01
CareSource Facility/Professional Facility Modifier Low / Median / High Price $1,954.31 / $2,283.92 / $2,283.92	Facility		$1,954.31	$2,283.92	$2,283.92
Cigna Facility/Professional Facility Modifier Low / Median / High Price $2,057.01 / $3,763.08 / $5,333.59	Facility		$2,057.01	$3,763.08	$5,333.59
Cigna Facility/Professional Professional Modifier Low / Median / High Price $1,427.45 / $2,115.09 / $15,189.45	Professional		$1,427.45	$2,115.09	$15,189.45
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $1,370.73 / $1,470.27 / $2,249.51	Facility		$1,370.73	$1,470.27	$2,249.51
Medica Facility/Professional Facility Modifier Low / Median / High Price $1,370.73 / $1,411.85 / $2,160.13	Facility		$1,370.73	$1,411.85	$2,160.13
Medica Facility/Professional Professional Modifier Low / Median / High Price $1,370.73 / $1,370.73 / $2,878.53	Professional		$1,370.73	$1,370.73	$2,878.53
Molina Facility/Professional Professional Modifier Low / Median / High Price $50.00 / $70.00 / $85.00	Professional		$50.00	$70.00	$85.00
Prevea360 Facility/Professional Facility Modifier Low / Median / High Price $1,370.73 / $1,470.27 / $2,249.51	Facility		$1,370.73	$1,470.27	$2,249.51
Quartz Facility/Professional Professional Modifier Low / Median / High Price $1,427.45 / $1,548.65 / $3,620.43	Professional		$1,427.45	$1,548.65	$3,620.43
Quartz Facility/Professional Facility Modifier Low / Median / High Price $1,387.09 / $1,537.00 / $6,525.00	Facility		$1,387.09	$1,537.00	$6,525.00
Quartz Facility/Professional Professional Modifier Low / Median / High Price $1,427.45 / $2,685.01 / $6,612.00	Professional		$1,427.45	$2,685.01	$6,612.00
Security Health Facility/Professional Professional Modifier Low / Median / High Price $2,004.14 / $2,004.14 / $2,004.14	Professional		$2,004.14	$2,004.14	$2,004.14
United Facility/Professional Facility Modifier Low / Median / High Price $2,982.24 / $2,982.24 / $3,245.79	Facility		$2,982.24	$2,982.24	$3,245.79
United Facility/Professional Professional Modifier Low / Median / High Price $1,427.45 / $1,427.45 / $1,954.46	Professional		$1,427.45	$1,427.45	$1,954.46