Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $1,959.70 / $1,959.70 / $1,959.70	Facility		$1,959.70	$1,959.70	$1,959.70
Aetna Facility/Professional Professional Modifier Low / Median / High Price $1,902.62 / $1,959.70 / $2,092.88	Professional		$1,902.62	$1,959.70	$2,092.88
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $1,712.35 / $1,902.62 / $2,853.93	Professional		$1,712.35	$1,902.62	$2,853.93
CareSource Facility/Professional Facility Modifier Low / Median / High Price $2,604.86 / $3,044.19 / $3,044.19	Facility		$2,604.86	$3,044.19	$3,044.19
Cigna Facility/Professional Facility Modifier Low / Median / High Price $3,298.61 / $6,034.44 / $8,552.90	Facility		$3,298.61	$6,034.44	$8,552.90
Cigna Facility/Professional Professional Modifier Low / Median / High Price $107.11 / $1,902.62 / $2,992.83	Professional		$107.11	$1,902.62	$2,992.83
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $1,902.62 / $1,978.73 / $2,998.34	Facility		$1,902.62	$1,978.73	$2,998.34
Medica Facility/Professional Facility Modifier Low / Median / High Price $2,038.50 / $2,099.66 / $3,212.48	Facility		$2,038.50	$2,099.66	$3,212.48
Medica Facility/Professional Professional Modifier Low / Median / High Price $2,038.50 / $2,038.50 / $4,280.85	Professional		$2,038.50	$2,038.50	$4,280.85
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 $1,902.62 / $1,978.73 / $2,998.34	Facility		$1,902.62	$1,978.73	$2,998.34
Quartz Facility/Professional Professional Modifier Low / Median / High Price $158.40 / $1,902.63 / $2,961.63	Professional		$158.40	$1,902.63	$2,961.63
Quartz Facility/Professional Facility Modifier Low / Median / High Price $2,349.92 / $3,125.84 / $8,437.50	Facility		$2,349.92	$3,125.84	$8,437.50
Quartz Facility/Professional Professional Modifier Low / Median / High Price $1,902.62 / $3,371.53 / $10,260.00	Professional		$1,902.62	$3,371.53	$10,260.00
Security Health Facility/Professional Professional Modifier Low / Median / High Price $2,671.28 / $2,671.28 / $2,671.28	Professional		$2,671.28	$2,671.28	$2,671.28
United Facility/Professional Professional Modifier Low / Median / High Price $1,902.62 / $1,902.62 / $2,473.41	Professional		$1,902.62	$1,902.62	$2,473.41