Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $627.72 / $1,331.37 / $14,482.00	Facility		$627.72	$1,331.37	$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 $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 $1,679.69 / $1,962.85 / $3,011.06	Facility		$1,679.69	$1,962.85	$3,011.06
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $627.72 / $840.00 / $1,350.80	Facility		$627.72	$840.00	$1,350.80
Medica Facility/Professional Facility Modifier Low / Median / High Price $627.72 / $1,275.44 / $13,442.00	Facility		$627.72	$1,275.44	$13,442.00
Prevea360 Facility/Professional Facility Modifier Low / Median / High Price $627.72 / $832.10 / $1,350.80	Facility		$627.72	$832.10	$1,350.80
Quartz Facility/Professional Professional Modifier Low / Median / High Price $1,271.40 / $1,549.15 / $2,312.58	Professional		$1,271.40	$1,549.15	$2,312.58
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 $5,266.00 / $11,608.00 / $13,980.00	Facility		$5,266.00	$11,608.00	$13,980.00