Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $626.70 / $6,616.61 / $17,823.00	Facility		$626.70	$6,616.61	$17,823.00
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $8,139.00 / $13,743.77 / $21,606.00	Facility		$8,139.00	$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 $1,665.27 / $1,946.00 / $2,985.21	Facility		$1,665.27	$1,946.00	$2,985.21
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $626.70 / $940.05 / $1,627.50	Facility		$626.70	$940.05	$1,627.50
Medica Facility/Professional Facility Modifier Low / Median / High Price $640.83 / $1,328.60 / $11,598.00	Facility		$640.83	$1,328.60	$11,598.00
Prevea360 Facility/Professional Facility Modifier Low / Median / High Price $626.70 / $940.05 / $1,627.50	Facility		$626.70	$940.05	$1,627.50
Quartz Facility/Professional Professional Modifier Low / Median / High Price $1,266.20 / $1,542.82 / $2,303.12	Professional		$1,266.20	$1,542.82	$2,303.12
Quartz Facility/Professional Facility Modifier Low / Median / High Price $9,410.98 / $9,410.98 / $25,978.45	Facility		$9,410.98	$9,410.98	$25,978.45
Quartz Facility/Professional Facility Modifier AS Low / Median / High Price $2,462.39 / $2,462.39 / $2,462.39	Facility	AS	$2,462.39	$2,462.39	$2,462.39
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