Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $1,417.08 / $1,417.08 / $1,417.08	Facility		$1,417.08	$1,417.08	$1,417.08
Aetna Facility/Professional Professional Modifier Low / Median / High Price $894.76 / $1,275.36 / $1,676.07	Professional		$894.76	$1,275.36	$1,676.07
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $2,126.80 / $3,870.78 / $3,870.78	Facility		$2,126.80	$3,870.78	$3,870.78
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $1,565.74 / $1,977.92 / $2,615.96	Professional		$1,565.74	$1,977.92	$2,615.96
CareSource Facility/Professional Facility Modifier Low / Median / High Price $152.38 / $153.01 / $455.14	Facility		$152.38	$153.01	$455.14
Cigna Facility/Professional Facility Modifier Low / Median / High Price $1,516.14 / $1,516.14 / $10,241.48	Facility		$1,516.14	$1,516.14	$10,241.48
Cigna Facility/Professional Professional Modifier Low / Median / High Price $169.88 / $2,463.75 / $3,079.69	Professional		$169.88	$2,463.75	$3,079.69
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $675.54 / $1,589.52 / $2,550.73	Facility		$675.54	$1,589.52	$2,550.73
DeanCare Facility/Professional Professional Modifier Low / Median / High Price $1,412.90 / $1,412.90 / $2,552.16	Professional		$1,412.90	$1,412.90	$2,552.16
Medica Facility/Professional Facility Modifier Low / Median / High Price $675.54 / $2,126.80 / $11,227.13	Facility		$675.54	$2,126.80	$11,227.13
Medica Facility/Professional Professional Modifier Low / Median / High Price $886.87 / $1,234.09 / $2,644.50	Professional		$886.87	$1,234.09	$2,644.50
Molina Facility/Professional Professional Modifier Low / Median / High Price $50.00 / $90.00 / $2,227.60	Professional		$50.00	$90.00	$2,227.60
Prevea360 Facility/Professional Facility Modifier Low / Median / High Price $675.54 / $1,764.92 / $2,550.73	Facility		$675.54	$1,764.92	$2,550.73
Prevea360 Facility/Professional Professional Modifier Low / Median / High Price $1,412.90 / $1,412.90 / $2,552.16	Professional		$1,412.90	$1,412.90	$2,552.16
Quartz Facility/Professional Professional Modifier Low / Median / High Price $238.86 / $500.10 / $649.34	Professional		$238.86	$500.10	$649.34
Quartz Facility/Professional Facility Modifier Low / Median / High Price $1,516.14 / $4,041.26 / $11,227.13	Facility		$1,516.14	$4,041.26	$11,227.13
Quartz Facility/Professional Professional Modifier Low / Median / High Price $169.88 / $169.88 / $1,743.98	Professional		$169.88	$169.88	$1,743.98
United Facility/Professional Professional Modifier Low / Median / High Price $847.30 / $1,147.33 / $2,126.80	Professional		$847.30	$1,147.33	$2,126.80