Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $1,999.90 / $1,999.90 / $1,999.90	Facility		$1,999.90	$1,999.90	$1,999.90
Aetna Facility/Professional Professional Modifier Low / Median / High Price $1,276.85 / $1,911.80 / $2,460.96	Professional		$1,276.85	$1,911.80	$2,460.96
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $2,239.80 / $2,463.78 / $4,076.44	Facility		$2,239.80	$2,463.78	$4,076.44
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $1,937.19 / $2,083.01 / $2,754.95	Professional		$1,937.19	$2,083.01	$2,754.95
CareSource Facility/Professional Facility Modifier Low / Median / High Price $157.90 / $479.32 / $479.32	Facility		$157.90	$479.32	$479.32
Cigna Facility/Professional Facility Modifier Low / Median / High Price $303.33 / $2,359.19 / $10,342.78	Facility		$303.33	$2,359.19	$10,342.78
Cigna Facility/Professional Professional Modifier Low / Median / High Price $257.83 / $2,887.50 / $3,609.38	Professional		$257.83	$2,887.50	$3,609.38
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $257.58 / $1,700.15 / $2,999.85	Facility		$257.58	$1,700.15	$2,999.85
DeanCare Facility/Professional Professional Modifier Low / Median / High Price $268.77 / $355.58 / $355.58	Professional		$268.77	$355.58	$355.58
Medica Facility/Professional Facility Modifier Low / Median / High Price $223.98 / $1,999.90 / $9,481.87	Facility		$223.98	$1,999.90	$9,481.87
Medica Facility/Professional Professional Modifier Low / Median / High Price $148.88 / $334.08 / $2,390.98	Professional		$148.88	$334.08	$2,390.98
Molina Facility/Professional Professional Modifier Low / Median / High Price $50.00 / $58.40 / $65.00	Professional		$50.00	$58.40	$65.00
Prevea360 Facility/Professional Facility Modifier Low / Median / High Price $223.98 / $1,700.15 / $2,999.85	Facility		$223.98	$1,700.15	$2,999.85
Prevea360 Facility/Professional Professional Modifier Low / Median / High Price $268.77 / $355.58 / $355.58	Professional		$268.77	$355.58	$355.58
Quartz Facility/Professional Professional Modifier Low / Median / High Price $230.37 / $422.80 / $548.97	Professional		$230.37	$422.80	$548.97
Quartz Facility/Professional Facility Modifier Low / Median / High Price $80.00 / $3,861.60 / $9,481.87	Facility		$80.00	$3,861.60	$9,481.87
Quartz Facility/Professional Professional Modifier Low / Median / High Price $192.51 / $303.33 / $303.33	Professional		$192.51	$303.33	$303.33
United Facility/Professional Professional Modifier Low / Median / High Price $148.88 / $324.27 / $2,308.96	Professional		$148.88	$324.27	$2,308.96