Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $2,093.28 / $2,093.28 / $2,093.28	Facility		$2,093.28	$2,093.28	$2,093.28
Aetna Facility/Professional Professional Modifier Low / Median / High Price $1,315.42 / $1,883.95 / $2,469.15	Professional		$1,315.42	$1,883.95	$2,469.15
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $3,145.80 / $5,725.36 / $5,725.36	Facility		$3,145.80	$5,725.36	$5,725.36
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $2,315.98 / $2,925.59 / $3,869.33	Professional		$2,315.98	$2,925.59	$3,869.33
CareSource Facility/Professional Facility Modifier Low / Median / High Price $223.56 / $343.83 / $1,022.79	Facility		$223.56	$343.83	$1,022.79
Cigna Facility/Professional Facility Modifier Low / Median / High Price $1,850.09 / $1,850.09 / $9,605.12	Facility		$1,850.09	$1,850.09	$9,605.12
Cigna Facility/Professional Professional Modifier Low / Median / High Price $1,572.58 / $3,648.75 / $4,560.93	Professional		$1,572.58	$3,648.75	$4,560.93
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $999.23 / $2,352.26 / $3,767.90	Facility		$999.23	$2,352.26	$3,767.90
DeanCare Facility/Professional Professional Modifier Low / Median / High Price $2,736.62 / $2,736.62 / $3,774.96	Professional		$2,736.62	$2,736.62	$3,774.96
Medica Facility/Professional Facility Modifier Low / Median / High Price $999.23 / $3,145.80 / $16,606.15	Facility		$999.23	$3,145.80	$16,606.15
Medica Facility/Professional Professional Modifier Low / Median / High Price $1,555.14 / $2,222.23 / $3,980.82	Professional		$1,555.14	$2,222.23	$3,980.82
Molina Facility/Professional Professional Modifier Low / Median / High Price $50.00 / $90.00 / $4,667.39	Professional		$50.00	$90.00	$4,667.39
Prevea360 Facility/Professional Facility Modifier Low / Median / High Price $999.23 / $3,078.69 / $3,767.90	Facility		$999.23	$3,078.69	$3,767.90
Prevea360 Facility/Professional Professional Modifier Low / Median / High Price $2,736.62 / $2,736.62 / $3,774.96	Professional		$2,736.62	$2,736.62	$3,774.96
Quartz Facility/Professional Professional Modifier Low / Median / High Price $353.29 / $739.89 / $960.70	Professional		$353.29	$739.89	$960.70
Quartz Facility/Professional Facility Modifier Low / Median / High Price $1,850.09 / $5,977.48 / $16,606.15	Facility		$1,850.09	$5,977.48	$16,606.15
Quartz Facility/Professional Professional Modifier Low / Median / High Price $249.23 / $1,850.09 / $1,850.09	Professional		$249.23	$1,850.09	$1,850.09
United Facility/Professional Professional Modifier Low / Median / High Price $1,405.44 / $2,204.60 / $3,980.82	Professional		$1,405.44	$2,204.60	$3,980.82