Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $2,202.55 / $2,202.55 / $2,202.55	Facility		$2,202.55	$2,202.55	$2,202.55
Aetna Facility/Professional Professional Modifier Low / Median / High Price $1,390.87 / $1,982.30 / $2,605.23	Professional		$1,390.87	$1,982.30	$2,605.23
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $3,305.80 / $6,016.56 / $6,016.56	Facility		$3,305.80	$6,016.56	$6,016.56
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $2,433.71 / $3,074.39 / $4,132.25	Professional		$2,433.71	$3,074.39	$4,132.25
CareSource Facility/Professional Facility Modifier Low / Median / High Price $237.82 / $707.44 / $7,646.88	Facility		$237.82	$707.44	$7,646.88
Cigna Facility/Professional Facility Modifier Low / Median / High Price $1,440.00 / $1,440.00 / $8,885.04	Facility		$1,440.00	$1,440.00	$8,885.04
Cigna Facility/Professional Professional Modifier Low / Median / High Price $1,224.00 / $3,832.50 / $4,790.63	Professional		$1,224.00	$3,832.50	$4,790.63
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $380.17 / $2,202.55 / $3,303.83	Facility		$380.17	$2,202.55	$3,303.83
DeanCare Facility/Professional Professional Modifier Low / Median / High Price $396.70 / $396.70 / $1,892.87	Professional		$396.70	$396.70	$1,892.87
Medica Facility/Professional Facility Modifier Low / Median / High Price $363.64 / $2,721.00 / $14,832.59	Facility		$363.64	$2,721.00	$14,832.59
Medica Facility/Professional Professional Modifier Low / Median / High Price $1,159.38 / $1,556.45 / $2,753.44	Professional		$1,159.38	$1,556.45	$2,753.44
Molina Facility/Professional Professional Modifier Low / Median / High Price $8.26 / $58.40 / $3,305.80	Professional		$8.26	$58.40	$3,305.80
Prevea360 Facility/Professional Facility Modifier Low / Median / High Price $380.17 / $2,202.55 / $3,303.83	Facility		$380.17	$2,202.55	$3,303.83
Prevea360 Facility/Professional Professional Modifier Low / Median / High Price $396.70 / $396.70 / $1,892.87	Professional		$396.70	$396.70	$1,892.87
Quartz Facility/Professional Professional Modifier Low / Median / High Price $371.25 / $661.01 / $858.28	Professional		$371.25	$661.01	$858.28
Quartz Facility/Professional Facility Modifier Low / Median / High Price $1,440.00 / $5,339.08 / $14,832.59	Facility		$1,440.00	$5,339.08	$14,832.59
Quartz Facility/Professional Professional Modifier Low / Median / High Price $233.64 / $1,440.00 / $1,468.00	Professional		$233.64	$1,440.00	$1,468.00
United Facility/Professional Professional Modifier Low / Median / High Price $1,137.28 / $1,537.09 / $2,594.08	Professional		$1,137.28	$1,537.09	$2,594.08