Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $1,495.82 / $1,495.82 / $1,495.82	Facility		$1,495.82	$1,495.82	$1,495.82
Aetna Facility/Professional Professional Modifier Low / Median / High Price $1,452.25 / $1,495.82 / $1,597.48	Professional		$1,452.25	$1,495.82	$1,597.48
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $1,452.25 / $1,452.25 / $2,381.69	Professional		$1,452.25	$1,452.25	$2,381.69
CareSource Facility/Professional Facility Modifier Low / Median / High Price $1,988.26 / $2,323.60 / $2,323.60	Facility		$1,988.26	$2,323.60	$2,323.60
Cigna Facility/Professional Facility Modifier Low / Median / High Price $1,243.57 / $2,274.96 / $3,224.42	Facility		$1,243.57	$2,274.96	$3,224.42
Cigna Facility/Professional Professional Modifier Low / Median / High Price $1,452.25 / $2,257.73 / $2,817.88	Professional		$1,452.25	$2,257.73	$2,817.88
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $1,452.25 / $1,510.34 / $2,288.60	Facility		$1,452.25	$1,510.34	$2,288.60
Medica Facility/Professional Facility Modifier Low / Median / High Price $1,725.04 / $1,776.79 / $2,718.49	Facility		$1,725.04	$1,776.79	$2,718.49
Medica Facility/Professional Professional Modifier Low / Median / High Price $1,725.04 / $1,725.04 / $3,622.58	Professional		$1,725.04	$1,725.04	$3,622.58
Molina Facility/Professional Professional Modifier Low / Median / High Price $50.00 / $60.00 / $85.00	Professional		$50.00	$60.00	$85.00
Prevea360 Facility/Professional Facility Modifier Low / Median / High Price $1,452.25 / $1,510.34 / $2,288.60	Facility		$1,452.25	$1,510.34	$2,288.60
Quartz Facility/Professional Professional Modifier Low / Median / High Price $1,452.25 / $1,782.29 / $3,815.06	Professional		$1,452.25	$1,782.29	$3,815.06
Quartz Facility/Professional Facility Modifier Low / Median / High Price $1,644.99 / $2,550.00 / $6,878.66	Facility		$1,644.99	$2,550.00	$6,878.66
Quartz Facility/Professional Professional Modifier Low / Median / High Price $1,452.25 / $2,866.11 / $6,878.66	Professional		$1,452.25	$2,866.11	$6,878.66
Security Health Facility/Professional Professional Modifier Low / Median / High Price $2,038.96 / $2,038.96 / $2,038.96	Professional		$2,038.96	$2,038.96	$2,038.96
United Facility/Professional Professional Modifier Low / Median / High Price $1,452.25 / $1,452.25 / $1,887.93	Professional		$1,452.25	$1,452.25	$1,887.93