Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $3,494.61 / $3,494.61 / $3,494.61	Facility		$3,494.61	$3,494.61	$3,494.61
Aetna Facility/Professional Professional Modifier Low / Median / High Price $2,196.04 / $3,145.15 / $4,122.18	Professional		$2,196.04	$3,145.15	$4,122.18
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $5,281.80 / $9,612.87 / $9,612.87	Facility		$5,281.80	$9,612.87	$9,612.87
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $3,893.06 / $4,912.07 / $6,496.61	Professional		$3,893.06	$4,912.07	$6,496.61
CareSource Facility/Professional Facility Modifier Low / Median / High Price $372.36 / $380.44 / $1,131.70	Facility		$372.36	$380.44	$1,131.70
Cigna Facility/Professional Facility Modifier Low / Median / High Price $3,248.38 / $3,248.38 / $16,035.84	Facility		$3,248.38	$3,248.38	$16,035.84
Cigna Facility/Professional Professional Modifier Low / Median / High Price $2,761.12 / $6,123.75 / $7,654.69	Professional		$2,761.12	$6,123.75	$7,654.69
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $1,679.67 / $4,391.30 / $6,290.30	Facility		$1,679.67	$4,391.30	$6,290.30
DeanCare Facility/Professional Professional Modifier Low / Median / High Price $3,513.04 / $3,513.04 / $6,338.16	Professional		$3,513.04	$3,513.04	$6,338.16
Medica Facility/Professional Facility Modifier Low / Median / High Price $1,679.67 / $5,281.80 / $27,719.97	Facility		$1,679.67	$5,281.80	$27,719.97
Medica Facility/Professional Professional Modifier Low / Median / High Price $2,205.11 / $3,028.97 / $6,490.65	Professional		$2,205.11	$3,028.97	$6,490.65
Molina Facility/Professional Professional Modifier Low / Median / High Price $50.00 / $90.00 / $4,348.60	Professional		$50.00	$90.00	$4,348.60
Prevea360 Facility/Professional Facility Modifier Low / Median / High Price $1,679.67 / $4,479.13 / $6,290.30	Facility		$1,679.67	$4,479.13	$6,290.30
Prevea360 Facility/Professional Professional Modifier Low / Median / High Price $3,513.04 / $3,513.04 / $6,338.16	Professional		$3,513.04	$3,513.04	$6,338.16
Quartz Facility/Professional Professional Modifier Low / Median / High Price $589.72 / $1,235.26 / $1,603.90	Professional		$589.72	$1,235.26	$1,603.90
Quartz Facility/Professional Facility Modifier Low / Median / High Price $3,248.38 / $9,977.98 / $27,719.97	Facility		$3,248.38	$9,977.98	$27,719.97
Quartz Facility/Professional Professional Modifier Low / Median / High Price $415.13 / $3,248.38 / $3,248.38	Professional		$415.13	$3,248.38	$3,248.38
United Facility/Professional Professional Modifier Low / Median / High Price $2,106.80 / $3,028.97 / $5,285.00	Professional		$2,106.80	$3,028.97	$5,285.00