Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $597.88 / $6,461.00 / $19,214.50	Facility		$597.88	$6,461.00	$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 $1,605.80 / $1,876.50 / $2,878.60	Facility		$1,605.80	$1,876.50	$2,878.60
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $597.88 / $895.67 / $1,393.40	Facility		$597.88	$895.67	$1,393.40
Medica Facility/Professional Facility Modifier Low / Median / High Price $597.88 / $1,254.06 / $11,598.00	Facility		$597.88	$1,254.06	$11,598.00
Prevea360 Facility/Professional Facility Modifier Low / Median / High Price $597.88 / $895.67 / $1,393.40	Facility		$597.88	$895.67	$1,393.40
Quartz Facility/Professional Professional Modifier Low / Median / High Price $1,208.34 / $1,472.33 / $2,197.90	Professional		$1,208.34	$1,472.33	$2,197.90
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 $6,241.00 / $9,837.00 / $12,062.00	Facility		$6,241.00	$9,837.00	$12,062.00