Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $6,563.27 / $6,563.27 / $6,563.27	Facility		$6,563.27	$6,563.27	$6,563.27
Aetna Facility/Professional Professional Modifier Low / Median / High Price $4,124.84 / $5,906.94 / $7,742.25	Professional		$4,124.84	$5,906.94	$7,742.25
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $9,719.60 / $17,689.66 / $17,689.66	Facility		$9,719.60	$17,689.66	$17,689.66
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $7,749.48 / $9,039.23 / $11,955.10	Professional		$7,749.48	$9,039.23	$11,955.10
CareSource Facility/Professional Facility Modifier Low / Median / High Price $685.22 / $757.30 / $2,252.71	Facility		$685.22	$757.30	$2,252.71
Cigna Facility/Professional Facility Modifier Low / Median / High Price $5,900.00 / $5,900.00 / $25,970.28	Facility		$5,900.00	$5,900.00	$25,970.28
Cigna Facility/Professional Professional Modifier Low / Median / High Price $5,015.00 / $11,268.75 / $14,085.94	Professional		$5,015.00	$11,268.75	$14,085.94
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $5,944.06 / $8,741.27 / $11,663.52	Facility		$5,944.06	$8,741.27	$11,663.52
DeanCare Facility/Professional Professional Modifier Low / Median / High Price $6,993.02 / $6,993.02 / $11,663.52	Professional		$6,993.02	$6,993.02	$11,663.52
Medica Facility/Professional Facility Modifier Low / Median / High Price $5,944.06 / $9,844.91 / $53,184.97	Facility		$5,944.06	$9,844.91	$53,184.97
Medica Facility/Professional Professional Modifier Low / Median / High Price $4,389.46 / $5,966.03 / $12,192.00	Professional		$4,389.46	$5,966.03	$12,192.00
Molina Facility/Professional Professional Modifier Low / Median / High Price $50.00 / $65.00 / $8,168.00	Professional		$50.00	$65.00	$8,168.00
Prevea360 Facility/Professional Facility Modifier Low / Median / High Price $5,944.06 / $8,766.90 / $11,663.52	Facility		$5,944.06	$8,766.90	$11,663.52
Prevea360 Facility/Professional Professional Modifier Low / Median / High Price $6,993.02 / $6,993.02 / $11,663.52	Professional		$6,993.02	$6,993.02	$11,663.52
Quartz Facility/Professional Professional Modifier Low / Median / High Price $1,085.20 / $2,370.34 / $3,077.72	Professional		$1,085.20	$2,370.34	$3,077.72
Quartz Facility/Professional Facility Modifier Low / Median / High Price $5,900.00 / $13,780.32 / $53,184.97	Facility		$5,900.00	$13,780.32	$53,184.97
Quartz Facility/Professional Professional Modifier Low / Median / High Price $763.91 / $5,900.00 / $6,018.00	Professional		$763.91	$5,900.00	$6,018.00
United Facility/Professional Professional Modifier Low / Median / High Price $3,774.60 / $5,966.03 / $11,777.07	Professional		$3,774.60	$5,966.03	$11,777.07