Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $1,207.22 / $1,207.22 / $1,207.22	Facility		$1,207.22	$1,207.22	$1,207.22
Aetna Facility/Professional Professional Modifier Low / Median / High Price $758.71 / $1,086.50 / $1,424.07	Professional		$758.71	$1,086.50	$1,424.07
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $1,795.40 / $3,267.63 / $3,267.63	Facility		$1,795.40	$3,267.63	$3,267.63
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $1,408.80 / $1,669.72 / $2,244.25	Professional		$1,408.80	$1,669.72	$2,244.25
CareSource Facility/Professional Facility Modifier Low / Median / High Price $126.57 / $224.27 / $667.15	Facility		$126.57	$224.27	$667.15
Cigna Facility/Professional Facility Modifier Low / Median / High Price $504.00 / $504.00 / $4,793.96	Facility		$504.00	$504.00	$4,793.96
Cigna Facility/Professional Professional Modifier Low / Median / High Price $428.40 / $2,081.25 / $2,601.56	Professional		$428.40	$2,081.25	$2,601.56
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $607.83 / $1,706.72 / $2,154.48	Facility		$607.83	$1,706.72	$2,154.48
DeanCare Facility/Professional Professional Modifier Low / Median / High Price $1,784.80 / $1,784.80 / $2,154.48	Professional		$1,784.80	$1,784.80	$2,154.48
Medica Facility/Professional Facility Modifier Low / Median / High Price $607.83 / $2,007.90 / $9,825.29	Facility		$607.83	$2,007.90	$9,825.29
Medica Facility/Professional Professional Modifier Low / Median / High Price $897.00 / $1,449.33 / $2,355.96	Professional		$897.00	$1,449.33	$2,355.96
Molina Facility/Professional Professional Modifier Low / Median / High Price $50.00 / $90.00 / $3,044.40	Professional		$50.00	$90.00	$3,044.40
Prevea360 Facility/Professional Facility Modifier Low / Median / High Price $607.83 / $1,795.40 / $2,154.48	Facility		$607.83	$1,795.40	$2,154.48
Prevea360 Facility/Professional Professional Modifier Low / Median / High Price $1,784.80 / $1,784.80 / $2,154.48	Professional		$1,784.80	$1,784.80	$2,154.48
Quartz Facility/Professional Professional Modifier Low / Median / High Price $200.46 / $437.78 / $568.42	Professional		$200.46	$437.78	$568.42
Quartz Facility/Professional Facility Modifier Low / Median / High Price $504.00 / $2,545.30 / $9,825.29	Facility		$504.00	$2,545.30	$9,825.29
Quartz Facility/Professional Professional Modifier Low / Median / High Price $141.11 / $504.00 / $504.00	Professional		$141.11	$504.00	$504.00
United Facility/Professional Professional Modifier Low / Median / High Price $895.13 / $1,241.95 / $2,295.79	Professional		$895.13	$1,241.95	$2,295.79