Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $1,024.14 / $10,047.28 / $24,086.60	Facility		$1,024.14	$10,047.28	$24,086.60
Aetna Facility/Professional Facility Modifier 50 Low / Median / High Price $15,035.52 / $15,035.52 / $15,035.52	Facility	50	$15,035.52	$15,035.52	$15,035.52
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $10,878.00 / $14,586.00 / $21,869.00	Facility		$10,878.00	$14,586.00	$21,869.00
CareSource Facility/Professional Facility Modifier Low / Median / High Price $1,003.51 / $1,264.92 / $10,788.07	Facility		$1,003.51	$1,264.92	$10,788.07
Cigna Facility/Professional Facility Modifier Low / Median / High Price $2,735.80 / $3,197.00 / $4,904.28	Facility		$2,735.80	$3,197.00	$4,904.28
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $1,024.14 / $1,433.80 / $2,408.40	Facility		$1,024.14	$1,433.80	$2,408.40
Medica Facility/Professional Facility Modifier Low / Median / High Price $1,024.14 / $2,171.17 / $15,090.00	Facility		$1,024.14	$2,171.17	$15,090.00
Prevea360 Facility/Professional Facility Modifier Low / Median / High Price $1,024.14 / $1,405.52 / $2,408.40	Facility		$1,024.14	$1,405.52	$2,408.40
Quartz Facility/Professional Professional Modifier Low / Median / High Price $2,098.19 / $2,556.58 / $3,816.46	Professional		$2,098.19	$2,556.58	$3,816.46
Quartz Facility/Professional Facility Modifier Low / Median / High Price $9,841.69 / $9,841.69 / $27,167.40	Facility		$9,841.69	$9,841.69	$27,167.40
Quartz Facility/Professional Facility Modifier AS Low / Median / High Price $2,575.09 / $2,575.09 / $2,575.09	Facility	AS	$2,575.09	$2,575.09	$2,575.09
United Facility/Professional Facility Modifier Low / Median / High Price $6,154.00 / $11,891.00 / $15,090.00	Facility		$6,154.00	$11,891.00	$15,090.00