Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $688.93 / $1,445.60 / $14,482.00	Facility		$688.93	$1,445.60	$14,482.00
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $1,905.00 / $3,496.00 / $5,962.00	Facility		$1,905.00	$3,496.00	$5,962.00
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 $1,827.47 / $2,135.54 / $3,275.98	Facility		$1,827.47	$2,135.54	$3,275.98
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $640.63 / $822.39 / $1,606.23	Facility		$640.63	$822.39	$1,606.23
Medica Facility/Professional Facility Modifier Low / Median / High Price $642.49 / $1,407.40 / $4,130.00	Facility		$642.49	$1,407.40	$4,130.00
Prevea360 Facility/Professional Facility Modifier Low / Median / High Price $640.63 / $822.39 / $1,606.23	Facility		$640.63	$822.39	$1,606.23
Quartz Facility/Professional Professional Modifier Low / Median / High Price $1,402.70 / $1,709.14 / $2,551.40	Professional		$1,402.70	$1,709.14	$2,551.40
Quartz Facility/Professional Facility Modifier Low / Median / High Price $1,455.33 / $1,455.33 / $4,994.64	Facility		$1,455.33	$1,455.33	$4,994.64
United Facility/Professional Facility Modifier Low / Median / High Price $1,957.00 / $3,068.00 / $4,295.00	Facility		$1,957.00	$3,068.00	$4,295.00