Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $744.38 / $6,461.00 / $19,245.56	Facility		$744.38	$6,461.00	$19,245.56
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 $9,978.21 / $9,978.21 / $9,978.21	Facility		$9,978.21	$9,978.21	$9,978.21
Cigna Facility/Professional Facility Modifier Low / Median / High Price $1,984.27 / $2,318.77 / $3,557.06	Facility		$1,984.27	$2,318.77	$3,557.06
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $744.38 / $1,078.14 / $1,741.18	Facility		$744.38	$1,078.14	$1,741.18
Medica Facility/Professional Facility Modifier Low / Median / High Price $744.38 / $1,543.74 / $14,270.00	Facility		$744.38	$1,543.74	$14,270.00
Prevea360 Facility/Professional Facility Modifier Low / Median / High Price $744.38 / $1,078.14 / $1,741.18	Facility		$744.38	$1,078.14	$1,741.18
Quartz Facility/Professional Professional Modifier Low / Median / High Price $1,516.45 / $1,847.74 / $2,758.31	Professional		$1,516.45	$1,847.74	$2,758.31
Quartz Facility/Professional Facility Modifier Low / Median / High Price $9,384.84 / $9,384.84 / $25,906.30	Facility		$9,384.84	$9,384.84	$25,906.30
Quartz Facility/Professional Facility Modifier AS Low / Median / High Price $2,455.55 / $2,455.55 / $2,455.55	Facility	AS	$2,455.55	$2,455.55	$2,455.55
United Facility/Professional Facility Modifier Low / Median / High Price $6,154.00 / $11,891.00 / $15,090.00	Facility		$6,154.00	$11,891.00	$15,090.00