Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $2,062.55 / $2,062.55 / $2,062.55	Facility		$2,062.55	$2,062.55	$2,062.55
Aetna Facility/Professional Professional Modifier Low / Median / High Price $1,302.50 / $1,856.30 / $2,439.63	Professional		$1,302.50	$1,856.30	$2,439.63
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $3,095.70 / $5,634.17 / $5,634.17	Facility		$3,095.70	$5,634.17	$5,634.17
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $2,321.77 / $2,879.00 / $3,869.62	Professional		$2,321.77	$2,879.00	$3,869.62
CareSource Facility/Professional Facility Modifier Low / Median / High Price $222.71 / $222.71 / $662.48	Facility		$222.71	$222.71	$662.48
Cigna Facility/Professional Facility Modifier Low / Median / High Price $1,406.76 / $1,406.76 / $9,451.52	Facility		$1,406.76	$1,406.76	$9,451.52
Cigna Facility/Professional Professional Modifier Low / Median / High Price $1,195.75 / $3,588.75 / $4,485.93	Professional		$1,195.75	$3,588.75	$4,485.93
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $356.01 / $1,506.70 / $3,093.83	Facility		$356.01	$1,506.70	$3,093.83
DeanCare Facility/Professional Professional Modifier Low / Median / High Price $371.48 / $371.48 / $1,772.58	Professional		$371.48	$371.48	$1,772.58
Medica Facility/Professional Facility Modifier Low / Median / High Price $340.53 / $2,429.40 / $13,890.95	Facility		$340.53	$2,429.40	$13,890.95
Medica Facility/Professional Professional Modifier Low / Median / High Price $1,085.76 / $1,517.23 / $2,985.94	Professional		$1,085.76	$1,517.23	$2,985.94
Molina Facility/Professional Professional Modifier Low / Median / High Price $7.74 / $58.40 / $3,095.70	Professional		$7.74	$58.40	$3,095.70
Prevea360 Facility/Professional Facility Modifier Low / Median / High Price $356.01 / $1,994.16 / $3,093.83	Facility		$356.01	$1,994.16	$3,093.83
Prevea360 Facility/Professional Professional Modifier Low / Median / High Price $371.48 / $371.48 / $1,772.58	Professional		$371.48	$371.48	$1,772.58
Quartz Facility/Professional Professional Modifier Low / Median / High Price $347.66 / $619.21 / $804.00	Professional		$347.66	$619.21	$804.00
Quartz Facility/Professional Facility Modifier Low / Median / High Price $1,406.76 / $5,000.14 / $13,890.95	Facility		$1,406.76	$5,000.14	$13,890.95
Quartz Facility/Professional Professional Modifier Low / Median / High Price $218.80 / $1,406.76 / $1,406.76	Professional		$218.80	$1,406.76	$1,406.76
United Facility/Professional Professional Modifier Low / Median / High Price $1,050.50 / $1,457.64 / $2,538.55	Professional		$1,050.50	$1,457.64	$2,538.55