Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $3,046.05 / $3,046.05 / $3,046.05	Facility		$3,046.05	$3,046.05	$3,046.05
Aetna Facility/Professional Professional Modifier Low / Median / High Price $1,914.35 / $2,741.45 / $3,593.25	Professional		$1,914.35	$2,741.45	$3,593.25
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $4,512.60 / $8,212.93 / $8,212.93	Facility		$4,512.60	$8,212.93	$8,212.93
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $3,593.34 / $4,196.72 / $5,550.49	Professional		$3,593.34	$4,196.72	$5,550.49
CareSource Facility/Professional Facility Modifier Low / Median / High Price $318.13 / $351.13 / $1,044.49	Facility		$318.13	$351.13	$1,044.49
Cigna Facility/Professional Facility Modifier Low / Median / High Price $2,200.00 / $2,200.00 / $12,056.99	Facility		$2,200.00	$2,200.00	$12,056.99
Cigna Facility/Professional Professional Modifier Low / Median / High Price $1,870.00 / $5,231.25 / $6,539.06	Professional		$1,870.00	$5,231.25	$6,539.06
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $2,592.00 / $4,113.02 / $5,415.12	Facility		$2,592.00	$4,113.02	$5,415.12
DeanCare Facility/Professional Professional Modifier Low / Median / High Price $3,242.57 / $3,242.57 / $5,415.12	Professional		$3,242.57	$3,242.57	$5,415.12
Medica Facility/Professional Facility Modifier Low / Median / High Price $2,592.00 / $4,569.08 / $24,693.27	Facility		$2,592.00	$4,569.08	$24,693.27
Medica Facility/Professional Professional Modifier Low / Median / High Price $2,035.33 / $2,767.87 / $5,658.45	Professional		$2,035.33	$2,767.87	$5,658.45
Molina Facility/Professional Professional Modifier Low / Median / High Price $50.00 / $90.00 / $3,790.80	Professional		$50.00	$90.00	$3,790.80
Prevea360 Facility/Professional Facility Modifier Low / Median / High Price $2,592.00 / $4,176.89 / $5,415.12	Facility		$2,592.00	$4,176.89	$5,415.12
Prevea360 Facility/Professional Professional Modifier Low / Median / High Price $3,242.57 / $3,242.57 / $5,415.12	Professional		$3,242.57	$3,242.57	$5,415.12
Quartz Facility/Professional Professional Modifier Low / Median / High Price $503.83 / $1,100.38 / $1,428.76	Professional		$503.83	$1,100.38	$1,428.76
Quartz Facility/Professional Facility Modifier Low / Median / High Price $2,200.00 / $6,397.98 / $24,693.27	Facility		$2,200.00	$6,397.98	$24,693.27
Quartz Facility/Professional Professional Modifier Low / Median / High Price $354.66 / $2,200.00 / $2,244.00	Professional		$354.66	$2,200.00	$2,244.00
United Facility/Professional Professional Modifier Low / Median / High Price $1,886.15 / $2,674.49 / $5,465.87	Professional		$1,886.15	$2,674.49	$5,465.87