Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $1,072.40 / $1,072.40 / $1,072.40	Facility		$1,072.40	$1,072.40	$1,072.40
Aetna Facility/Professional Professional Modifier Low / Median / High Price $673.92 / $965.16 / $1,265.04	Professional		$673.92	$965.16	$1,265.04
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $1,621.20 / $2,950.58 / $2,950.58	Facility		$1,621.20	$2,950.58	$2,950.58
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $1,194.02 / $1,507.72 / $2,026.50	Professional		$1,194.02	$1,507.72	$2,026.50
CareSource Facility/Professional Facility Modifier Low / Median / High Price $114.29 / $116.69 / $347.11	Facility		$114.29	$116.69	$347.11
Cigna Facility/Professional Facility Modifier Low / Median / High Price $902.06 / $902.06 / $4,334.39	Facility		$902.06	$902.06	$4,334.39
Cigna Facility/Professional Professional Modifier Low / Median / High Price $766.75 / $1,878.75 / $2,348.44	Professional		$766.75	$1,878.75	$2,348.44
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $515.16 / $1,212.15 / $1,930.32	Facility		$515.16	$1,212.15	$1,930.32
DeanCare Facility/Professional Professional Modifier Low / Median / High Price $1,077.46 / $1,077.46 / $1,945.44	Professional		$1,077.46	$1,077.46	$1,945.44
Medica Facility/Professional Facility Modifier Low / Median / High Price $515.16 / $1,621.20 / $8,508.41	Facility		$515.16	$1,621.20	$8,508.41
Medica Facility/Professional Professional Modifier Low / Median / High Price $676.32 / $929.53 / $1,991.85	Professional		$676.32	$929.53	$1,991.85
Molina Facility/Professional Professional Modifier Low / Median / High Price $50.00 / $90.00 / $1,693.80	Professional		$50.00	$90.00	$1,693.80
Prevea360 Facility/Professional Facility Modifier Low / Median / High Price $515.16 / $1,373.77 / $1,930.32	Facility		$515.16	$1,373.77	$1,930.32
Prevea360 Facility/Professional Professional Modifier Low / Median / High Price $1,077.46 / $1,077.46 / $1,945.44	Professional		$1,077.46	$1,077.46	$1,945.44
Quartz Facility/Professional Professional Modifier Low / Median / High Price $181.00 / $379.41 / $492.64	Professional		$181.00	$379.41	$492.64
Quartz Facility/Professional Facility Modifier Low / Median / High Price $902.06 / $3,062.64 / $8,508.41	Facility		$902.06	$3,062.64	$8,508.41
Quartz Facility/Professional Professional Modifier Low / Median / High Price $127.42 / $902.06 / $902.06	Professional		$127.42	$902.06	$902.06
United Facility/Professional Facility Modifier Low / Median / High Price $84.08 / $680.15 / $1,168.98	Facility		$84.08	$680.15	$1,168.98
United Facility/Professional Professional Modifier Low / Median / High Price $646.20 / $929.53 / $1,924.06	Professional		$646.20	$929.53	$1,924.06