Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $2,786.70 / $2,786.70 / $2,786.70	Facility		$2,786.70	$2,786.70	$2,786.70
Aetna Facility/Professional Professional Modifier Low / Median / High Price $1,759.77 / $2,508.03 / $3,296.16	Professional		$1,759.77	$2,508.03	$3,296.16
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $4,182.50 / $7,612.15 / $7,612.15	Facility		$4,182.50	$7,612.15	$7,612.15
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $2,951.75 / $3,889.73 / $5,228.12	Professional		$2,951.75	$3,889.73	$5,228.12
CareSource Facility/Professional Facility Modifier Low / Median / High Price $300.89 / $300.89 / $895.06	Facility		$300.89	$300.89	$895.06
Cigna Facility/Professional Facility Modifier Low / Median / High Price $2,569.13 / $2,569.13 / $12,769.28	Facility		$2,569.13	$2,569.13	$12,769.28
Cigna Facility/Professional Professional Modifier Low / Median / High Price $2,183.76 / $4,848.75 / $6,060.94	Professional		$2,183.76	$4,848.75	$6,060.94
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $260.39 / $480.99 / $4,180.05	Facility		$260.39	$480.99	$4,180.05
DeanCare Facility/Professional Professional Modifier Low / Median / High Price $501.90 / $501.90 / $501.90	Professional		$501.90	$501.90	$501.90
Medica Facility/Professional Facility Modifier Low / Median / High Price $80.00 / $418.25 / $4,180.05	Facility		$80.00	$418.25	$4,180.05
Medica Facility/Professional Professional Modifier Low / Median / High Price $163.99 / $273.31 / $1,969.03	Professional		$163.99	$273.31	$1,969.03
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 $260.39 / $480.99 / $4,180.05	Facility		$260.39	$480.99	$4,180.05
Prevea360 Facility/Professional Professional Modifier Low / Median / High Price $501.90 / $501.90 / $501.90	Professional		$501.90	$501.90	$501.90
Quartz Facility/Professional Professional Modifier Low / Median / High Price $469.72 / $836.13 / $1,085.65	Professional		$469.72	$836.13	$1,085.65
Quartz Facility/Professional Facility Modifier Low / Median / High Price $65.00 / $80.00 / $2,569.13	Facility		$65.00	$80.00	$2,569.13
Quartz Facility/Professional Professional Modifier Low / Median / High Price $295.60 / $2,569.13 / $2,569.13	Professional		$295.60	$2,569.13	$2,569.13
United Facility/Professional Professional Modifier Low / Median / High Price $150.32 / $250.95 / $520.89	Professional		$150.32	$250.95	$520.89