Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $4,478.32 / $4,478.32 / $4,478.32	Facility		$4,478.32	$4,478.32	$4,478.32
Aetna Facility/Professional Professional Modifier Low / Median / High Price $2,871.94 / $3,968.56 / $5,389.47	Professional		$2,871.94	$3,968.56	$5,389.47
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $5,925.80 / $6,518.38 / $10,784.96	Facility		$5,925.80	$6,518.38	$10,784.96
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $4,428.68 / $5,510.99 / $7,288.73	Professional		$4,428.68	$5,510.99	$7,288.73
CareSource Facility/Professional Facility Modifier Low / Median / High Price $417.76 / $1,268.11 / $1,268.11	Facility		$417.76	$1,268.11	$1,268.11
Cigna Facility/Professional Facility Modifier Low / Median / High Price $422.50 / $17,571.84 / $27,719.84	Facility		$422.50	$17,571.84	$27,719.84
Cigna Facility/Professional Professional Modifier Low / Median / High Price $479.92 / $6,708.75 / $8,385.94	Professional		$479.92	$6,708.75	$8,385.94
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $524.05 / $2,947.82 / $6,717.48	Facility		$524.05	$2,947.82	$6,717.48
DeanCare Facility/Professional Professional Modifier Low / Median / High Price $616.54 / $616.54 / $711.10	Professional		$616.54	$616.54	$711.10
Medica Facility/Professional Facility Modifier Low / Median / High Price $524.05 / $6,110.32 / $29,293.49	Facility		$524.05	$6,110.32	$29,293.49
Medica Facility/Professional Professional Modifier Low / Median / High Price $2,667.78 / $3,634.78 / $6,013.56	Professional		$2,667.78	$3,634.78	$6,013.56
Molina Facility/Professional Professional Modifier Low / Median / High Price $10.41 / $58.40 / $4,269.08	Professional		$10.41	$58.40	$4,269.08
Prevea360 Facility/Professional Facility Modifier Low / Median / High Price $524.05 / $2,947.82 / $6,717.48	Facility		$524.05	$2,947.82	$6,717.48
Prevea360 Facility/Professional Professional Modifier Low / Median / High Price $616.54 / $616.54 / $711.10	Professional		$616.54	$616.54	$711.10
Quartz Facility/Professional Professional Modifier Low / Median / High Price $661.62 / $1,305.46 / $1,695.05	Professional		$661.62	$1,305.46	$1,695.05
Quartz Facility/Professional Facility Modifier Low / Median / High Price $65.00 / $10,544.38 / $29,293.49	Facility		$65.00	$10,544.38	$29,293.49
Quartz Facility/Professional Professional Modifier Low / Median / High Price $422.50 / $422.50 / $479.92	Professional		$422.50	$422.50	$479.92
United Facility/Professional Professional Modifier Low / Median / High Price $2,470.69 / $3,634.78 / $6,013.56	Professional		$2,470.69	$3,634.78	$6,013.56