Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $2,403.66 / $2,403.66 / $2,403.66	Facility		$2,403.66	$2,403.66	$2,403.66
Aetna Facility/Professional Professional Modifier Low / Median / High Price $1,713.06 / $2,139.23 / $2,877.12	Professional		$1,713.06	$2,139.23	$2,877.12
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $3,607.70 / $3,968.47 / $6,566.01	Facility		$3,607.70	$3,968.47	$6,566.01
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $2,339.10 / $3,355.16 / $4,437.47	Professional		$2,339.10	$3,355.16	$4,437.47
CareSource Facility/Professional Facility Modifier Low / Median / High Price $259.52 / $772.05 / $772.05	Facility		$259.52	$772.05	$772.05
Cigna Facility/Professional Facility Modifier Low / Median / High Price $9,587.92 / $11,204.24 / $17,187.59	Facility		$9,587.92	$11,204.24	$17,187.59
Cigna Facility/Professional Professional Modifier Low / Median / High Price $2,837.98 / $4,177.60 / $5,170.31	Professional		$2,837.98	$4,177.60	$5,170.31
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $244.30 / $1,114.60 / $3,834.29	Facility		$244.30	$1,114.60	$3,834.29
DeanCare Facility/Professional Professional Modifier Low / Median / High Price $432.92 / $1,575.26 / $1,575.26	Professional		$432.92	$1,575.26	$1,575.26
Medica Facility/Professional Facility Modifier Low / Median / High Price $356.75 / $3,195.24 / $18,269.96	Facility		$356.75	$3,195.24	$18,269.96
Medica Facility/Professional Professional Modifier Low / Median / High Price $1,314.98 / $1,916.82 / $3,391.13	Professional		$1,314.98	$1,916.82	$3,391.13
Molina Facility/Professional Professional Modifier Low / Median / High Price $4.84 / $58.40 / $3,606.48	Professional		$4.84	$58.40	$3,606.48
Prevea360 Facility/Professional Facility Modifier Low / Median / High Price $244.30 / $1,927.62 / $4,089.91	Facility		$244.30	$1,927.62	$4,089.91
Prevea360 Facility/Professional Professional Modifier Low / Median / High Price $432.92 / $1,575.26 / $1,575.26	Professional		$432.92	$1,575.26	$1,575.26
Quartz Facility/Professional Professional Modifier Low / Median / High Price $405.16 / $814.04 / $1,056.97	Professional		$405.16	$814.04	$1,056.97
Quartz Facility/Professional Facility Modifier Low / Median / High Price $2,264.27 / $6,576.38 / $18,269.96	Facility		$2,264.27	$6,576.38	$18,269.96
Quartz Facility/Professional Professional Modifier Low / Median / High Price $287.76 / $287.76 / $2,837.98	Professional		$287.76	$287.76	$2,837.98
United Facility/Professional Professional Modifier Low / Median / High Price $1,314.98 / $1,796.18 / $3,195.24	Professional		$1,314.98	$1,796.18	$3,195.24