Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $1,795.71 / $1,795.71 / $1,795.71	Facility		$1,795.71	$1,795.71	$1,795.71
Aetna Facility/Professional Professional Modifier Low / Median / High Price $1,133.98 / $1,616.14 / $2,124.00	Professional		$1,133.98	$1,616.14	$2,124.00
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $2,695.20 / $4,905.26 / $4,905.26	Facility		$2,695.20	$4,905.26	$4,905.26
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $1,984.08 / $2,506.54 / $3,315.09	Professional		$1,984.08	$2,506.54	$3,315.09
CareSource Facility/Professional Facility Modifier Low / Median / High Price $193.89 / $193.89 / $576.77	Facility		$193.89	$193.89	$576.77
Cigna Facility/Professional Facility Modifier Low / Median / High Price $1,208.78 / $1,208.78 / $7,245.00	Facility		$1,208.78	$1,208.78	$7,245.00
Cigna Facility/Professional Professional Modifier Low / Median / High Price $1,027.46 / $3,123.75 / $3,904.69	Professional		$1,027.46	$3,123.75	$3,904.69
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $309.95 / $1,311.69 / $2,693.57	Facility		$309.95	$1,311.69	$2,693.57
DeanCare Facility/Professional Professional Modifier Low / Median / High Price $323.42 / $323.42 / $1,543.16	Professional		$323.42	$323.42	$1,543.16
Medica Facility/Professional Facility Modifier Low / Median / High Price $296.47 / $2,114.89 / $12,092.66	Facility		$296.47	$2,114.89	$12,092.66
Medica Facility/Professional Professional Modifier Low / Median / High Price $945.19 / $1,268.94 / $2,244.75	Professional		$945.19	$1,268.94	$2,244.75
Molina Facility/Professional Professional Modifier Low / Median / High Price $6.73 / $58.40 / $2,695.20	Professional		$6.73	$58.40	$2,695.20
Prevea360 Facility/Professional Facility Modifier Low / Median / High Price $309.95 / $1,736.06 / $2,693.57	Facility		$309.95	$1,736.06	$2,693.57
Prevea360 Facility/Professional Professional Modifier Low / Median / High Price $323.42 / $323.42 / $1,543.16	Professional		$323.42	$323.42	$1,543.16
Quartz Facility/Professional Professional Modifier Low / Median / High Price $302.68 / $538.75 / $699.53	Professional		$302.68	$538.75	$699.53
Quartz Facility/Professional Facility Modifier Low / Median / High Price $1,208.78 / $4,352.82 / $12,092.66	Facility		$1,208.78	$4,352.82	$12,092.66
Quartz Facility/Professional Professional Modifier Low / Median / High Price $190.49 / $1,208.78 / $1,208.78	Professional		$190.49	$1,208.78	$1,208.78
United Facility/Professional Professional Modifier Low / Median / High Price $914.60 / $1,268.94 / $2,835.56	Professional		$914.60	$1,268.94	$2,835.56