Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $658.77 / $1,393.16 / $14,482.00	Facility		$658.77	$1,393.16	$14,482.00
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 $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 $1,762.59 / $2,059.73 / $3,159.67	Facility		$1,762.59	$2,059.73	$3,159.67
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $658.77 / $928.77 / $1,416.36	Facility		$658.77	$928.77	$1,416.36
Medica Facility/Professional Facility Modifier Low / Median / High Price $658.77 / $1,325.49 / $15,090.00	Facility		$658.77	$1,325.49	$15,090.00
Prevea360 Facility/Professional Facility Modifier Low / Median / High Price $658.77 / $922.28 / $1,416.36	Facility		$658.77	$922.28	$1,416.36
Quartz Facility/Professional Professional Modifier Low / Median / High Price $1,331.20 / $1,622.02 / $2,421.35	Professional		$1,331.20	$1,622.02	$2,421.35
Quartz Facility/Professional Facility Modifier Low / Median / High Price $10,011.60 / $10,011.60 / $27,636.40	Facility		$10,011.60	$10,011.60	$27,636.40
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