Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $207.88 / $441.05 / $1,894.00	Facility		$207.88	$441.05	$1,894.00
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $2,740.00 / $4,780.00 / $7,344.00	Facility		$2,740.00	$4,780.00	$7,344.00
CareSource Facility/Professional Facility Modifier Low / Median / High Price $1,507.48 / $1,507.48 / $1,507.48	Facility		$1,507.48	$1,507.48	$1,507.48
Cigna Facility/Professional Facility Modifier Low / Median / High Price $953.39 / $1,114.10 / $1,709.07	Facility		$953.39	$1,114.10	$1,709.07
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $207.88 / $362.37 / $731.48	Facility		$207.88	$362.37	$731.48
Medica Facility/Professional Facility Modifier Low / Median / High Price $213.01 / $428.18 / $7,160.00	Facility		$213.01	$428.18	$7,160.00
Prevea360 Facility/Professional Facility Modifier Low / Median / High Price $207.88 / $362.37 / $731.48	Facility		$207.88	$362.37	$731.48
Quartz Facility/Professional Professional Modifier Low / Median / High Price $504.14 / $781.50 / $1,211.89	Professional		$504.14	$781.50	$1,211.89
Quartz Facility/Professional Facility Modifier Low / Median / High Price $1,012.24 / $1,012.24 / $2,469.60	Facility		$1,012.24	$1,012.24	$2,469.60
United Facility/Professional Facility Modifier Low / Median / High Price $4,918.00 / $6,477.00 / $8,384.00	Facility		$4,918.00	$6,477.00	$8,384.00