Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $3,068.94 / $3,068.94 / $3,068.94	Facility		$3,068.94	$3,068.94	$3,068.94
Aetna Facility/Professional Professional Modifier Low / Median / High Price $2,979.56 / $3,068.94 / $3,277.51	Professional		$2,979.56	$3,068.94	$3,277.51
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $2,979.56 / $2,979.56 / $4,469.34	Professional		$2,979.56	$2,979.56	$4,469.34
CareSource Facility/Professional Facility Modifier Low / Median / High Price $4,079.30 / $4,767.30 / $4,767.30	Facility		$4,079.30	$4,767.30	$4,767.30
Cigna Facility/Professional Facility Modifier Low / Median / High Price $2,979.55 / $2,979.55 / $2,979.55	Facility		$2,979.55	$2,979.55	$2,979.55
Cigna Facility/Professional Professional Modifier Low / Median / High Price $2,979.55 / $2,979.55 / $3,435.76	Professional		$2,979.55	$2,979.55	$3,435.76
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $2,901.66 / $3,068.94 / $4,695.47	Facility		$2,901.66	$3,068.94	$4,695.47
Medica Facility/Professional Facility Modifier Low / Median / High Price $2,901.66 / $2,988.70 / $4,572.71	Facility		$2,901.66	$2,988.70	$4,572.71
Medica Facility/Professional Professional Modifier Low / Median / High Price $2,901.66 / $2,901.66 / $6,093.49	Professional		$2,901.66	$2,901.66	$6,093.49
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 $2,901.66 / $3,068.94 / $4,695.47	Facility		$2,901.66	$3,068.94	$4,695.47
Quartz Facility/Professional Professional Modifier Low / Median / High Price $2,979.55 / $2,979.56 / $4,637.99	Professional		$2,979.55	$2,979.56	$4,637.99
Quartz Facility/Professional Facility Modifier Low / Median / High Price $2,863.13 / $3,808.51 / $9,187.50	Facility		$2,863.13	$3,808.51	$9,187.50
Quartz Facility/Professional Professional Modifier Low / Median / High Price $2,979.55 / $3,021.00 / $9,975.00	Professional		$2,979.55	$3,021.00	$9,975.00
Security Health Facility/Professional Professional Modifier Low / Median / High Price $4,183.30 / $4,183.30 / $4,183.30	Professional		$4,183.30	$4,183.30	$4,183.30
United Facility/Professional Professional Modifier Low / Median / High Price $2,979.56 / $2,979.56 / $4,079.61	Professional		$2,979.56	$2,979.56	$4,079.61