Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $1,726.27 / $1,726.27 / $1,726.27	Facility		$1,726.27	$1,726.27	$1,726.27
Aetna Facility/Professional Professional Modifier Low / Median / High Price $1,123.07 / $1,531.97 / $2,103.57	Professional		$1,123.07	$1,531.97	$2,103.57
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $2,590.90 / $4,715.43 / $4,715.43	Facility		$2,590.90	$4,715.43	$4,715.43
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $1,997.01 / $2,409.54 / $3,186.80	Professional		$1,997.01	$2,409.54	$3,186.80
CareSource Facility/Professional Facility Modifier Low / Median / High Price $186.39 / $186.39 / $554.45	Facility		$186.39	$186.39	$554.45
Cigna Facility/Professional Facility Modifier Low / Median / High Price $1,639.62 / $1,639.62 / $7,802.88	Facility		$1,639.62	$1,639.62	$7,802.88
Cigna Facility/Professional Professional Modifier Low / Median / High Price $1,393.68 / $2,962.50 / $3,703.13	Professional		$1,393.68	$2,962.50	$3,703.13
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $297.95 / $1,299.19 / $2,589.41	Facility		$297.95	$1,299.19	$2,589.41
DeanCare Facility/Professional Professional Modifier Low / Median / High Price $310.91 / $310.91 / $1,299.19	Professional		$310.91	$310.91	$1,299.19
Medica Facility/Professional Facility Modifier Low / Median / High Price $293.62 / $2,094.77 / $11,977.62	Facility		$293.62	$2,094.77	$11,977.62
Medica Facility/Professional Professional Modifier Low / Median / High Price $936.17 / $1,256.85 / $2,223.32	Professional		$936.17	$1,256.85	$2,223.32
Molina Facility/Professional Professional Modifier Low / Median / High Price $1.81 / $58.40 / $822.05	Professional		$1.81	$58.40	$822.05
Prevea360 Facility/Professional Facility Modifier Low / Median / High Price $297.95 / $1,668.75 / $2,589.41	Facility		$297.95	$1,668.75	$2,589.41
Prevea360 Facility/Professional Professional Modifier Low / Median / High Price $310.91 / $310.91 / $1,299.19	Professional		$310.91	$310.91	$1,299.19
Quartz Facility/Professional Professional Modifier Low / Median / High Price $290.97 / $534.02 / $693.38	Professional		$290.97	$534.02	$693.38
Quartz Facility/Professional Facility Modifier Low / Median / High Price $1,639.62 / $4,311.39 / $11,977.62	Facility		$1,639.62	$4,311.39	$11,977.62
Quartz Facility/Professional Professional Modifier Low / Median / High Price $188.66 / $1,639.62 / $1,639.62	Professional		$188.66	$1,639.62	$1,639.62
United Facility/Professional Professional Modifier Low / Median / High Price $905.75 / $1,242.34 / $2,574.55	Professional		$905.75	$1,242.34	$2,574.55