Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $1,122.24 / $1,122.24 / $1,122.24	Facility		$1,122.24	$1,122.24	$1,122.24
Aetna Facility/Professional Professional Modifier Low / Median / High Price $705.23 / $1,010.02 / $1,323.72	Professional		$705.23	$1,010.02	$1,323.72
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $1,696.20 / $3,087.08 / $3,087.08	Facility		$1,696.20	$3,087.08	$3,087.08
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $1,350.37 / $1,577.47 / $2,120.25	Professional		$1,350.37	$1,577.47	$2,120.25
CareSource Facility/Professional Facility Modifier Low / Median / High Price $119.58 / $237.48 / $706.46	Facility		$119.58	$237.48	$706.46
Cigna Facility/Professional Facility Modifier Low / Median / High Price $799.37 / $799.37 / $4,532.63	Facility		$799.37	$799.37	$4,532.63
Cigna Facility/Professional Professional Modifier Low / Median / High Price $679.46 / $1,965.00 / $2,456.25	Professional		$679.46	$1,965.00	$2,456.25
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $539.46 / $1,606.56 / $2,035.44	Facility		$539.46	$1,606.56	$2,035.44
DeanCare Facility/Professional Professional Modifier Low / Median / High Price $1,890.07 / $1,890.07 / $2,035.44	Professional		$1,890.07	$1,890.07	$2,035.44
Medica Facility/Professional Facility Modifier Low / Median / High Price $539.46 / $2,126.33 / $8,901.35	Facility		$539.46	$2,126.33	$8,901.35
Medica Facility/Professional Professional Modifier Low / Median / High Price $833.76 / $1,534.81 / $2,362.59	Professional		$833.76	$1,534.81	$2,362.59
Molina Facility/Professional Professional Modifier Low / Median / High Price $50.00 / $90.00 / $3,223.80	Professional		$50.00	$90.00	$3,223.80
Prevea360 Facility/Professional Facility Modifier Low / Median / High Price $539.46 / $1,683.36 / $2,035.44	Facility		$539.46	$1,683.36	$2,035.44
Prevea360 Facility/Professional Professional Modifier Low / Median / High Price $1,890.07 / $1,890.07 / $2,035.44	Professional		$1,890.07	$1,890.07	$2,035.44
Quartz Facility/Professional Professional Modifier Low / Median / High Price $189.38 / $396.77 / $515.16	Professional		$189.38	$396.77	$515.16
Quartz Facility/Professional Facility Modifier Low / Median / High Price $799.37 / $3,204.10 / $8,901.35	Facility		$799.37	$3,204.10	$8,901.35
Quartz Facility/Professional Professional Modifier Low / Median / High Price $133.31 / $799.37 / $799.37	Professional		$133.31	$799.37	$799.37
United Facility/Professional Professional Modifier Low / Median / High Price $833.76 / $1,315.10 / $2,189.87	Professional		$833.76	$1,315.10	$2,189.87