Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $4,213.37 / $4,213.37 / $4,213.37	Facility		$4,213.37	$4,213.37	$4,213.37
Aetna Facility/Professional Professional Modifier Low / Median / High Price $2,731.19 / $3,786.43 / $5,125.50	Professional		$2,731.19	$3,786.43	$5,125.50
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $5,614.20 / $6,175.62 / $10,217.84	Facility		$5,614.20	$6,175.62	$10,217.84
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $4,327.68 / $5,221.21 / $6,905.46	Professional		$4,327.68	$5,221.21	$6,905.46
CareSource Facility/Professional Facility Modifier Low / Median / High Price $395.80 / $1,201.44 / $1,201.44	Facility		$395.80	$1,201.44	$1,201.44
Cigna Facility/Professional Facility Modifier Low / Median / High Price $200.00 / $17,008.64 / $26,831.38	Facility		$200.00	$17,008.64	$26,831.38
Cigna Facility/Professional Professional Modifier Low / Median / High Price $462.00 / $6,495.00 / $8,118.75	Professional		$462.00	$6,495.00	$8,118.75
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $486.50 / $2,736.54 / $6,320.06	Facility		$486.50	$2,736.54	$6,320.06
DeanCare Facility/Professional Professional Modifier Low / Median / High Price $673.70 / $3,867.45 / $3,867.45	Professional		$673.70	$3,867.45	$3,867.45
Medica Facility/Professional Facility Modifier Low / Median / High Price $560.16 / $7,584.07 / $21,533.82	Facility		$560.16	$7,584.07	$21,533.82
Medica Facility/Professional Professional Modifier Low / Median / High Price $2,389.40 / $3,333.39 / $5,247.68	Professional		$2,389.40	$3,333.39	$5,247.68
Molina Facility/Professional Professional Modifier Low / Median / High Price $9.91 / $58.40 / $4,067.36	Professional		$9.91	$58.40	$4,067.36
Prevea360 Facility/Professional Facility Modifier Low / Median / High Price $486.50 / $4,213.37 / $6,320.06	Facility		$486.50	$4,213.37	$6,320.06
Prevea360 Facility/Professional Professional Modifier Low / Median / High Price $673.70 / $3,867.45 / $3,867.45	Professional		$673.70	$3,867.45	$3,867.45
Quartz Facility/Professional Professional Modifier Low / Median / High Price $626.83 / $1,327.55 / $1,723.73	Professional		$626.83	$1,327.55	$1,723.73
Quartz Facility/Professional Facility Modifier Low / Median / High Price $3,417.67 / $8,589.84 / $21,533.82	Facility		$3,417.67	$8,589.84	$21,533.82
Quartz Facility/Professional Professional Modifier Low / Median / High Price $200.00 / $462.00 / $3,344.98	Professional		$200.00	$462.00	$3,344.98
United Facility/Professional Professional Modifier Low / Median / High Price $2,195.33 / $3,050.31 / $5,243.76	Professional		$2,195.33	$3,050.31	$5,243.76