Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $1,990.87 / $1,990.87 / $1,990.87	Facility		$1,990.87	$1,990.87	$1,990.87
Aetna Facility/Professional Professional Modifier Low / Median / High Price $1,257.20 / $1,791.78 / $2,354.85	Professional		$1,257.20	$1,791.78	$2,354.85
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $2,988.00 / $5,438.16 / $5,438.16	Facility		$2,988.00	$5,438.16	$5,438.16
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $2,199.53 / $2,778.84 / $3,675.24	Professional		$2,199.53	$2,778.84	$3,675.24
CareSource Facility/Professional Facility Modifier Low / Median / High Price $214.96 / $214.96 / $639.42	Facility		$214.96	$214.96	$639.42
Cigna Facility/Professional Facility Modifier Low / Median / High Price $1,219.64 / $1,219.64 / $8,028.98	Facility		$1,219.64	$1,219.64	$8,028.98
Cigna Facility/Professional Professional Modifier Low / Median / High Price $1,036.69 / $3,465.00 / $4,331.25	Professional		$1,036.69	$3,465.00	$4,331.25
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $343.62 / $1,454.12 / $2,986.31	Facility		$343.62	$1,454.12	$2,986.31
DeanCare Facility/Professional Professional Modifier Low / Median / High Price $358.56 / $358.56 / $1,710.73	Professional		$358.56	$358.56	$1,710.73
Medica Facility/Professional Facility Modifier Low / Median / High Price $328.68 / $2,344.89 / $13,407.77	Facility		$328.68	$2,344.89	$13,407.77
Medica Facility/Professional Professional Modifier Low / Median / High Price $1,048.04 / $1,406.93 / $2,489.02	Professional		$1,048.04	$1,406.93	$2,489.02
Molina Facility/Professional Professional Modifier Low / Median / High Price $7.47 / $58.40 / $2,988.00	Professional		$7.47	$58.40	$2,988.00
Prevea360 Facility/Professional Facility Modifier Low / Median / High Price $343.62 / $1,924.57 / $2,986.31	Facility		$343.62	$1,924.57	$2,986.31
Prevea360 Facility/Professional Professional Modifier Low / Median / High Price $358.56 / $358.56 / $1,710.73	Professional		$358.56	$358.56	$1,710.73
Quartz Facility/Professional Professional Modifier Low / Median / High Price $335.57 / $597.12 / $775.32	Professional		$335.57	$597.12	$775.32
Quartz Facility/Professional Facility Modifier Low / Median / High Price $1,219.64 / $4,826.20 / $13,407.77	Facility		$1,219.64	$4,826.20	$13,407.77
Quartz Facility/Professional Professional Modifier Low / Median / High Price $211.18 / $1,219.64 / $1,219.64	Professional		$211.18	$1,219.64	$1,219.64
United Facility/Professional Professional Modifier Low / Median / High Price $1,013.84 / $1,464.28 / $2,489.02	Professional		$1,013.84	$1,464.28	$2,489.02