Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $1,794.73 / $1,794.73 / $1,794.73	Facility		$1,794.73	$1,794.73	$1,794.73
Aetna Facility/Professional Professional Modifier Low / Median / High Price $1,127.92 / $1,615.26 / $2,117.16	Professional		$1,127.92	$1,615.26	$2,117.16
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $2,666.40 / $4,852.85 / $4,852.85	Facility		$2,666.40	$4,852.85	$4,852.85
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $2,100.40 / $2,479.75 / $3,333.00	Professional		$2,100.40	$2,479.75	$3,333.00
CareSource Facility/Professional Facility Modifier Low / Median / High Price $187.99 / $205.26 / $610.58	Facility		$187.99	$205.26	$610.58
Cigna Facility/Professional Facility Modifier Low / Median / High Price $1,350.00 / $1,350.00 / $7,127.86	Facility		$1,350.00	$1,350.00	$7,127.86
Cigna Facility/Professional Professional Modifier Low / Median / High Price $1,147.50 / $3,090.00 / $3,862.50	Professional		$1,147.50	$3,090.00	$3,862.50
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $1,611.06 / $2,132.28 / $3,199.68	Facility		$1,611.06	$2,132.28	$3,199.68
DeanCare Facility/Professional Professional Modifier Low / Median / High Price $1,895.36 / $1,895.36 / $3,199.68	Professional		$1,895.36	$1,895.36	$3,199.68
Medica Facility/Professional Facility Modifier Low / Median / High Price $1,611.06 / $2,692.10 / $14,590.13	Facility		$1,611.06	$2,692.10	$14,590.13
Medica Facility/Professional Professional Modifier Low / Median / High Price $1,189.70 / $1,625.61 / $3,333.90	Professional		$1,189.70	$1,625.61	$3,333.90
Molina Facility/Professional Professional Modifier Low / Median / High Price $50.00 / $65.00 / $2,889.50	Professional		$50.00	$65.00	$2,889.50
Prevea360 Facility/Professional Facility Modifier Low / Median / High Price $1,611.06 / $2,346.00 / $3,199.68	Facility		$1,611.06	$2,346.00	$3,199.68
Prevea360 Facility/Professional Professional Modifier Low / Median / High Price $1,895.36 / $1,895.36 / $3,199.68	Professional		$1,895.36	$1,895.36	$3,199.68
Quartz Facility/Professional Professional Modifier Low / Median / High Price $297.70 / $649.97 / $843.94	Professional		$297.70	$649.97	$843.94
Quartz Facility/Professional Facility Modifier Low / Median / High Price $1,350.00 / $3,780.68 / $14,590.13	Facility		$1,350.00	$3,780.68	$14,590.13
Quartz Facility/Professional Professional Modifier Low / Median / High Price $209.56 / $1,350.00 / $1,377.00	Professional		$209.56	$1,350.00	$1,377.00
United Facility/Professional Professional Modifier Low / Median / High Price $1,111.30 / $1,577.94 / $2,642.47	Professional		$1,111.30	$1,577.94	$2,642.47