Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $2,028.98 / $2,028.98 / $2,028.98	Facility		$2,028.98	$2,028.98	$2,028.98
Aetna Facility/Professional Professional Modifier Low / Median / High Price $1,969.89 / $2,028.98 / $2,166.88	Professional		$1,969.89	$2,028.98	$2,166.88
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $1,969.89 / $1,969.89 / $2,954.83	Professional		$1,969.89	$1,969.89	$2,954.83
CareSource Facility/Professional Facility Modifier Low / Median / High Price $2,696.96 / $3,151.82 / $3,151.82	Facility		$2,696.96	$3,151.82	$3,151.82
Cigna Facility/Professional Facility Modifier Low / Median / High Price $1,969.89 / $1,969.89 / $1,969.89	Facility		$1,969.89	$1,969.89	$1,969.89
Cigna Facility/Professional Professional Modifier Low / Median / High Price $1,969.89 / $1,969.89 / $2,230.06	Professional		$1,969.89	$1,969.89	$2,230.06
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $1,789.55 / $2,028.98 / $3,104.34	Facility		$1,789.55	$2,028.98	$3,104.34
Medica Facility/Professional Facility Modifier Low / Median / High Price $1,789.55 / $1,843.23 / $2,820.14	Facility		$1,789.55	$1,843.23	$2,820.14
Medica Facility/Professional Professional Modifier Low / Median / High Price $1,789.55 / $1,789.55 / $3,758.06	Professional		$1,789.55	$1,789.55	$3,758.06
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 $1,789.55 / $2,028.98 / $3,104.34	Facility		$1,789.55	$2,028.98	$3,104.34
Quartz Facility/Professional Professional Modifier Low / Median / High Price $1,969.88 / $1,969.89 / $3,066.33	Professional		$1,969.88	$1,969.89	$3,066.33
Quartz Facility/Professional Facility Modifier Low / Median / High Price $2,296.02 / $2,566.14 / $4,051.80	Facility		$2,296.02	$2,566.14	$4,051.80
Quartz Facility/Professional Professional Modifier Low / Median / High Price $1,969.89 / $2,863.27 / $9,454.20	Professional		$1,969.89	$2,863.27	$9,454.20
Security Health Facility/Professional Professional Modifier Low / Median / High Price $2,765.73 / $2,765.73 / $2,765.73	Professional		$2,765.73	$2,765.73	$2,765.73
United Facility/Professional Professional Modifier Low / Median / High Price $1,969.89 / $1,969.89 / $2,702.16	Professional		$1,969.89	$1,969.89	$2,702.16