Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $612.40 / $1,894.00 / $19,214.50	Facility		$612.40	$1,894.00	$19,214.50
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $5,692.00 / $13,743.77 / $21,606.00	Facility		$5,692.00	$13,743.77	$21,606.00
CareSource Facility/Professional Facility Modifier Low / Median / High Price $7,560.77 / $7,560.77 / $7,560.77	Facility		$7,560.77	$7,560.77	$7,560.77
Cigna Facility/Professional Facility Modifier Low / Median / High Price $1,638.24 / $1,914.41 / $2,936.75	Facility		$1,638.24	$1,914.41	$2,936.75
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $612.40 / $847.51 / $1,425.75	Facility		$612.40	$847.51	$1,425.75
Medica Facility/Professional Facility Modifier Low / Median / High Price $612.40 / $1,191.11 / $11,598.00	Facility		$612.40	$1,191.11	$11,598.00
Prevea360 Facility/Professional Facility Modifier Low / Median / High Price $612.40 / $847.51 / $1,425.75	Facility		$612.40	$847.51	$1,425.75
Quartz Facility/Professional Professional Modifier Low / Median / High Price $1,238.25 / $1,508.76 / $2,252.28	Professional		$1,238.25	$1,508.76	$2,252.28
Quartz Facility/Professional Facility Modifier Low / Median / High Price $7,213.88 / $7,213.88 / $19,913.50	Facility		$7,213.88	$7,213.88	$19,913.50
Quartz Facility/Professional Facility Modifier AS Low / Median / High Price $1,887.52 / $1,887.52 / $1,887.52	Facility	AS	$1,887.52	$1,887.52	$1,887.52
United Facility/Professional Facility Modifier Low / Median / High Price $4,240.00 / $9,837.00 / $12,631.00	Facility		$4,240.00	$9,837.00	$12,631.00