Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $1,877.26 / $1,877.26 / $1,877.26	Facility		$1,877.26	$1,877.26	$1,877.26
Aetna Facility/Professional Professional Modifier Low / Median / High Price $1,185.49 / $1,689.53 / $2,220.48	Professional		$1,185.49	$1,689.53	$2,220.48
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $2,817.50 / $5,127.85 / $5,127.85	Facility		$2,817.50	$5,127.85	$5,127.85
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $2,074.35 / $2,620.28 / $3,521.87	Professional		$2,074.35	$2,620.28	$3,521.87
CareSource Facility/Professional Facility Modifier Low / Median / High Price $202.70 / $258.52 / $769.03	Facility		$202.70	$258.52	$769.03
Cigna Facility/Professional Facility Modifier Low / Median / High Price $213.28 / $1,414.26 / $7,569.41	Facility		$213.28	$1,414.26	$7,569.41
Cigna Facility/Professional Professional Modifier Low / Median / High Price $213.28 / $3,266.25 / $4,082.81	Professional		$213.28	$3,266.25	$4,082.81
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $771.39 / $1,877.26 / $3,379.07	Facility		$771.39	$1,877.26	$3,379.07
DeanCare Facility/Professional Professional Modifier Low / Median / High Price $2,057.67 / $2,057.67 / $3,381.00	Professional		$2,057.67	$2,057.67	$3,381.00
Medica Facility/Professional Facility Modifier Low / Median / High Price $771.39 / $2,817.50 / $12,643.10	Facility		$771.39	$2,817.50	$12,643.10
Medica Facility/Professional Professional Modifier Low / Median / High Price $1,291.58 / $1,691.76 / $3,328.18	Professional		$1,291.58	$1,691.76	$3,328.18
Molina Facility/Professional Professional Modifier Low / Median / High Price $50.00 / $58.40 / $65.00	Professional		$50.00	$58.40	$65.00
Prevea360 Facility/Professional Facility Modifier Low / Median / High Price $771.39 / $2,815.89 / $3,379.07	Facility		$771.39	$2,815.89	$3,379.07
Prevea360 Facility/Professional Professional Modifier Low / Median / High Price $2,057.67 / $2,057.67 / $3,381.00	Professional		$2,057.67	$2,057.67	$3,381.00
Quartz Facility/Professional Professional Modifier Low / Median / High Price $316.42 / $563.20 / $731.28	Professional		$316.42	$563.20	$731.28
Quartz Facility/Professional Facility Modifier Low / Median / High Price $213.28 / $4,550.96 / $12,643.10	Facility		$213.28	$4,550.96	$12,643.10
Quartz Facility/Professional Professional Modifier Low / Median / High Price $199.14 / $1,414.26 / $1,414.26	Professional		$199.14	$1,414.26	$1,414.26
United Facility/Professional Professional Modifier Low / Median / High Price $1,194.83 / $1,690.50 / $3,138.25	Professional		$1,194.83	$1,690.50	$3,138.25