Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $1,573.69 / $8,878.34 / $39,621.16	Facility		$1,573.69	$8,878.34	$39,621.16
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $12,080.00 / $17,505.00 / $23,937.00	Facility		$12,080.00	$17,505.00	$23,937.00
CareSource Facility/Professional Facility Modifier Low / Median / High Price $1,628.95 / $2,046.86 / $21,128.13	Facility		$1,628.95	$2,046.86	$21,128.13
Cigna Facility/Professional Facility Modifier Low / Median / High Price $4,155.97 / $4,856.57 / $7,450.11	Facility		$4,155.97	$4,856.57	$7,450.11
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $1,573.69 / $2,204.94 / $3,541.53	Facility		$1,573.69	$2,204.94	$3,541.53
Medica Facility/Professional Facility Modifier Low / Median / High Price $1,605.31 / $3,336.22 / $17,327.00	Facility		$1,605.31	$3,336.22	$17,327.00
Prevea360 Facility/Professional Facility Modifier Low / Median / High Price $1,573.69 / $2,204.94 / $3,541.53	Facility		$1,573.69	$2,204.94	$3,541.53
Quartz Facility/Professional Professional Modifier Low / Median / High Price $3,363.10 / $4,097.81 / $6,117.22	Professional		$3,363.10	$4,097.81	$6,117.22
Quartz Facility/Professional Facility Modifier Low / Median / High Price $18,634.52 / $18,634.52 / $51,439.50	Facility		$18,634.52	$18,634.52	$51,439.50
Quartz Facility/Professional Facility Modifier 62 Low / Median / High Price $30,473.31 / $30,473.31 / $30,473.31	Facility	62	$30,473.31	$30,473.31	$30,473.31
Quartz Facility/Professional Facility Modifier AS Low / Median / High Price $4,875.72 / $4,875.72 / $4,875.72	Facility	AS	$4,875.72	$4,875.72	$4,875.72
United Facility/Professional Facility Modifier Low / Median / High Price $8,627.00 / $12,708.00 / $27,414.00	Facility		$8,627.00	$12,708.00	$27,414.00