Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $6,687.17 / $6,687.17 / $6,687.17	Facility		$6,687.17	$6,687.17	$6,687.17
Aetna Facility/Professional Professional Modifier Low / Median / High Price $4,202.56 / $6,018.45 / $7,888.23	Professional		$4,202.56	$6,018.45	$7,888.23
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $9,969.70 / $18,144.84 / $18,144.84	Facility		$9,969.70	$18,144.84	$18,144.84
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $8,370.20 / $9,271.82 / $12,462.12	Professional		$8,370.20	$9,271.82	$12,462.12
CareSource Facility/Professional Facility Modifier Low / Median / High Price $702.84 / $757.35 / $2,252.86	Facility		$702.84	$757.35	$2,252.86
Cigna Facility/Professional Facility Modifier Low / Median / High Price $4,933.43 / $4,933.43 / $26,637.11	Facility		$4,933.43	$4,933.43	$26,637.11
Cigna Facility/Professional Professional Modifier Low / Median / High Price $4,193.42 / $11,557.50 / $14,446.88	Professional		$4,193.42	$11,557.50	$14,446.88
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $3,343.83 / $8,742.04 / $11,963.64	Facility		$3,343.83	$8,742.04	$11,963.64
DeanCare Facility/Professional Professional Modifier Low / Median / High Price $6,993.64 / $6,993.64 / $11,963.64	Professional		$6,993.64	$6,993.64	$11,963.64
Medica Facility/Professional Facility Modifier Low / Median / High Price $3,343.83 / $10,030.76 / $54,554.97	Facility		$3,343.83	$10,030.76	$54,554.97
Medica Facility/Professional Professional Modifier Low / Median / High Price $4,389.85 / $5,986.16 / $12,421.50	Professional		$4,389.85	$5,986.16	$12,421.50
Molina Facility/Professional Professional Modifier Low / Median / High Price $50.00 / $90.00 / $8,321.90	Professional		$50.00	$90.00	$8,321.90
Prevea360 Facility/Professional Facility Modifier Low / Median / High Price $3,343.83 / $8,916.89 / $11,963.64	Facility		$3,343.83	$8,916.89	$11,963.64
Prevea360 Facility/Professional Professional Modifier Low / Median / High Price $6,993.64 / $6,993.64 / $11,963.64	Professional		$6,993.64	$6,993.64	$11,963.64
Quartz Facility/Professional Professional Modifier Low / Median / High Price $1,113.11 / $2,431.08 / $3,156.58	Professional		$1,113.11	$2,431.08	$3,156.58
Quartz Facility/Professional Facility Modifier Low / Median / High Price $4,933.43 / $14,135.20 / $54,554.97	Facility		$4,933.43	$14,135.20	$54,554.97
Quartz Facility/Professional Professional Modifier Low / Median / High Price $783.57 / $4,933.43 / $4,933.43	Professional		$783.57	$4,933.43	$4,933.43
United Facility/Professional Facility Modifier Low / Median / High Price $438.98 / $3,891.02 / $6,668.40	Facility		$438.98	$3,891.02	$6,668.40
United Facility/Professional Professional Modifier Low / Median / High Price $3,871.72 / $5,986.16 / $11,998.75	Professional		$3,871.72	$5,986.16	$11,998.75