Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $1,103.14 / $12,789.44 / $45,123.58	Facility		$1,103.14	$12,789.44	$45,123.58
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $12,080.00 / $17,505.00 / $23,937.00	Facility		$12,080.00	$17,505.00	$23,937.00
CareSource Facility/Professional Facility Modifier Low / Median / High Price $20,478.49 / $20,478.49 / $20,478.49	Facility		$20,478.49	$20,478.49	$20,478.49
Cigna Facility/Professional Facility Modifier Low / Median / High Price $2,926.84 / $3,420.24 / $5,246.74	Facility		$2,926.84	$3,420.24	$5,246.74
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $1,103.14 / $1,617.60 / $2,582.44	Facility		$1,103.14	$1,617.60	$2,582.44
Medica Facility/Professional Facility Modifier Low / Median / High Price $1,103.14 / $2,324.21 / $21,512.00	Facility		$1,103.14	$2,324.21	$21,512.00
Prevea360 Facility/Professional Facility Modifier Low / Median / High Price $1,103.14 / $1,617.60 / $2,582.44	Facility		$1,103.14	$1,617.60	$2,582.44
Quartz Facility/Professional Professional Modifier Low / Median / High Price $2,266.55 / $2,761.70 / $4,122.68	Professional		$2,266.55	$2,761.70	$4,122.68
Quartz Facility/Professional Facility Modifier Low / Median / High Price $18,661.58 / $18,661.58 / $51,514.20	Facility		$18,661.58	$18,661.58	$51,514.20
Quartz Facility/Professional Facility Modifier AS Low / Median / High Price $4,882.81 / $4,882.81 / $4,882.81	Facility	AS	$4,882.81	$4,882.81	$4,882.81
United Facility/Professional Facility Modifier Low / Median / High Price $7,775.00 / $14,566.00 / $27,414.00	Facility		$7,775.00	$14,566.00	$27,414.00