Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $2,110.85 / $2,110.85 / $2,110.85	Facility		$2,110.85	$2,110.85	$2,110.85
Aetna Facility/Professional Professional Modifier Low / Median / High Price $1,326.64 / $1,899.77 / $2,490.12	Professional		$1,326.64	$1,899.77	$2,490.12
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $3,115.00 / $3,426.50 / $5,669.30	Facility		$3,115.00	$3,426.50	$5,669.30
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $1,636.06 / $2,896.95 / $3,831.45	Professional		$1,636.06	$2,896.95	$3,831.45
CareSource Facility/Professional Facility Modifier Low / Median / High Price $219.61 / $666.61 / $666.61	Facility		$219.61	$666.61	$666.61
Cigna Facility/Professional Facility Modifier Low / Median / High Price $1,950.00 / $8,326.35 / $12,931.97	Facility		$1,950.00	$8,326.35	$12,931.97
Cigna Facility/Professional Professional Modifier Low / Median / High Price $1,657.50 / $3,611.25 / $4,514.06	Professional		$1,657.50	$3,611.25	$4,514.06
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $358.23 / $1,930.26 / $3,577.22	Facility		$358.23	$1,930.26	$3,577.22
DeanCare Facility/Professional Professional Modifier Low / Median / High Price $373.80 / $2,270.90 / $2,270.90	Professional		$373.80	$2,270.90	$2,270.90
Medica Facility/Professional Facility Modifier Low / Median / High Price $358.23 / $2,981.02 / $17,045.09	Facility		$358.23	$2,981.02	$17,045.09
Medica Facility/Professional Professional Modifier Low / Median / High Price $1,136.76 / $1,589.39 / $2,981.02	Professional		$1,136.76	$1,589.39	$2,981.02
Molina Facility/Professional Professional Modifier Low / Median / High Price $6.22 / $58.40 / $2,554.30	Professional		$6.22	$58.40	$2,554.30
Prevea360 Facility/Professional Facility Modifier Low / Median / High Price $358.23 / $2,110.85 / $3,799.53	Facility		$358.23	$2,110.85	$3,799.53
Prevea360 Facility/Professional Professional Modifier Low / Median / High Price $373.80 / $2,270.90 / $2,270.90	Professional		$373.80	$2,270.90	$2,270.90
Quartz Facility/Professional Professional Modifier Low / Median / High Price $347.79 / $759.61 / $986.30	Professional		$347.79	$759.61	$986.30
Quartz Facility/Professional Facility Modifier Low / Median / High Price $1,950.00 / $3,737.96 / $17,045.09	Facility		$1,950.00	$3,737.96	$17,045.09
Quartz Facility/Professional Professional Modifier Low / Median / High Price $244.82 / $1,950.00 / $1,950.00	Professional		$244.82	$1,950.00	$1,950.00
United Facility/Professional Professional Modifier Low / Median / High Price $1,027.16 / $1,585.86 / $2,924.34	Professional		$1,027.16	$1,585.86	$2,924.34