Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $640.41 / $1,345.07 / $14,482.00	Facility		$640.41	$1,345.07	$14,482.00
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $9,287.00 / $13,743.77 / $21,606.00	Facility		$9,287.00	$13,743.77	$21,606.00
CareSource Facility/Professional Facility Modifier Low / Median / High Price $10,563.20 / $10,563.20 / $10,563.20	Facility		$10,563.20	$10,563.20	$10,563.20
Cigna Facility/Professional Facility Modifier Low / Median / High Price $1,713.93 / $2,002.86 / $3,072.44	Facility		$1,713.93	$2,002.86	$3,072.44
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $640.41 / $896.59 / $1,357.69	Facility		$640.41	$896.59	$1,357.69
Medica Facility/Professional Facility Modifier Low / Median / High Price $640.41 / $1,231.39 / $13,250.00	Facility		$640.41	$1,231.39	$13,250.00
Prevea360 Facility/Professional Facility Modifier Low / Median / High Price $640.41 / $895.90 / $1,357.69	Facility		$640.41	$895.90	$1,357.69
Quartz Facility/Professional Professional Modifier Low / Median / High Price $1,295.45 / $1,578.46 / $2,356.32	Professional		$1,295.45	$1,578.46	$2,356.32
Quartz Facility/Professional Facility Modifier Low / Median / High Price $9,615.75 / $9,615.75 / $26,543.70	Facility		$9,615.75	$9,615.75	$26,543.70
Quartz Facility/Professional Facility Modifier AS Low / Median / High Price $2,515.96 / $2,515.96 / $2,515.96	Facility	AS	$2,515.96	$2,515.96	$2,515.96
United Facility/Professional Facility Modifier Low / Median / High Price $5,266.00 / $11,608.00 / $13,980.00	Facility		$5,266.00	$11,608.00	$13,980.00