Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $635.83 / $2,395.33 / $14,735.84	Facility		$635.83	$2,395.33	$14,735.84
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $10,878.00 / $14,586.00 / $21,869.00	Facility		$10,878.00	$14,586.00	$21,869.00
CareSource Facility/Professional Facility Modifier Low / Median / High Price $9,838.74 / $9,838.74 / $9,838.74	Facility		$9,838.74	$9,838.74	$9,838.74
Cigna Facility/Professional Facility Modifier Low / Median / High Price $1,695.91 / $1,981.80 / $3,040.14	Facility		$1,695.91	$1,981.80	$3,040.14
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $635.83 / $947.37 / $1,493.35	Facility		$635.83	$947.37	$1,493.35
Medica Facility/Professional Facility Modifier Low / Median / High Price $635.83 / $1,321.54 / $15,090.00	Facility		$635.83	$1,321.54	$15,090.00
Prevea360 Facility/Professional Facility Modifier Low / Median / High Price $635.83 / $947.37 / $1,493.35	Facility		$635.83	$947.37	$1,493.35
Quartz Facility/Professional Professional Modifier Low / Median / High Price $1,292.20 / $1,574.50 / $2,350.41	Professional		$1,292.20	$1,574.50	$2,350.41
Quartz Facility/Professional Facility Modifier Low / Median / High Price $9,362.45 / $9,362.45 / $25,844.45	Facility		$9,362.45	$9,362.45	$25,844.45
Quartz Facility/Professional Facility Modifier AS Low / Median / High Price $2,449.69 / $2,449.69 / $2,449.69	Facility	AS	$2,449.69	$2,449.69	$2,449.69
United Facility/Professional Facility Modifier Low / Median / High Price $8,627.00 / $12,373.00 / $15,090.00	Facility		$8,627.00	$12,373.00	$15,090.00