Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $1,538.74 / $1,538.74 / $1,538.74	Facility		$1,538.74	$1,538.74	$1,538.74
Aetna Facility/Professional Professional Modifier Low / Median / High Price $971.72 / $1,384.87 / $1,820.07	Professional		$971.72	$1,384.87	$1,820.07
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $2,309.50 / $4,203.29 / $4,203.29	Facility		$2,309.50	$4,203.29	$4,203.29
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $1,700.29 / $2,147.84 / $2,840.68	Professional		$1,700.29	$2,147.84	$2,840.68
CareSource Facility/Professional Facility Modifier Low / Median / High Price $166.15 / $166.15 / $494.23	Facility		$166.15	$166.15	$494.23
Cigna Facility/Professional Facility Modifier Low / Median / High Price $171.39 / $1,071.00 / $7,055.36	Facility		$171.39	$1,071.00	$7,055.36
Cigna Facility/Professional Professional Modifier Low / Median / High Price $171.39 / $2,677.50 / $3,346.88	Professional		$171.39	$2,677.50	$3,346.88
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $265.58 / $1,124.07 / $2,308.11	Facility		$265.58	$1,124.07	$2,308.11
DeanCare Facility/Professional Professional Modifier Low / Median / High Price $277.14 / $277.14 / $1,322.44	Professional		$277.14	$277.14	$1,322.44
Medica Facility/Professional Facility Modifier Low / Median / High Price $254.05 / $1,812.45 / $10,363.37	Facility		$254.05	$1,812.45	$10,363.37
Medica Facility/Professional Professional Modifier Low / Median / High Price $810.03 / $1,131.93 / $2,227.67	Professional		$810.03	$1,131.93	$2,227.67
Molina Facility/Professional Professional Modifier Low / Median / High Price $5.77 / $58.40 / $2,309.50	Professional		$5.77	$58.40	$2,309.50
Prevea360 Facility/Professional Facility Modifier Low / Median / High Price $265.58 / $1,487.75 / $2,308.11	Facility		$265.58	$1,487.75	$2,308.11
Prevea360 Facility/Professional Professional Modifier Low / Median / High Price $277.14 / $277.14 / $1,322.44	Professional		$277.14	$277.14	$1,322.44
Quartz Facility/Professional Professional Modifier Low / Median / High Price $259.37 / $461.45 / $599.16	Professional		$259.37	$461.45	$599.16
Quartz Facility/Professional Facility Modifier Low / Median / High Price $1,071.00 / $3,730.36 / $10,363.37	Facility		$1,071.00	$3,730.36	$10,363.37
Quartz Facility/Professional Professional Modifier Low / Median / High Price $163.22 / $1,071.00 / $1,071.00	Professional		$163.22	$1,071.00	$1,071.00
United Facility/Professional Professional Modifier Low / Median / High Price $783.65 / $1,087.49 / $1,923.77	Professional		$783.65	$1,087.49	$1,923.77