Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $2,740.01 / $2,740.01 / $2,740.01	Facility		$2,740.01	$2,740.01	$2,740.01
Aetna Facility/Professional Professional Modifier Low / Median / High Price $1,721.85 / $2,466.01 / $3,232.08	Professional		$1,721.85	$2,466.01	$3,232.08
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $4,120.89 / $7,500.04 / $7,500.04	Facility		$4,120.89	$7,500.04	$7,500.04
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $3,033.82 / $3,832.44 / $5,151.12	Professional		$3,033.82	$3,832.44	$5,151.12
CareSource Facility/Professional Facility Modifier Low / Median / High Price $292.56 / $296.45 / $881.87	Facility		$292.56	$296.45	$881.87
Cigna Facility/Professional Facility Modifier Low / Median / High Price $2,399.94 / $2,399.94 / $11,074.76	Facility		$2,399.94	$2,399.94	$11,074.76
Cigna Facility/Professional Professional Modifier Low / Median / High Price $2,039.95 / $4,777.50 / $5,971.88	Professional		$2,039.95	$4,777.50	$5,971.88
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $1,308.95 / $3,079.88 / $4,932.02	Facility		$1,308.95	$3,079.88	$4,932.02
DeanCare Facility/Professional Professional Modifier Low / Median / High Price $2,737.67 / $2,737.67 / $4,945.08	Professional		$2,737.67	$2,737.67	$4,945.08
Medica Facility/Professional Facility Modifier Low / Median / High Price $1,308.95 / $4,120.89 / $21,753.30	Facility		$1,308.95	$4,120.89	$21,753.30
Medica Facility/Professional Professional Modifier Low / Median / High Price $1,718.41 / $2,374.89 / $5,089.05	Professional		$1,718.41	$2,374.89	$5,089.05
Molina Facility/Professional Professional Modifier Low / Median / High Price $50.00 / $90.00 / $4,316.10	Professional		$50.00	$90.00	$4,316.10
Prevea360 Facility/Professional Facility Modifier Low / Median / High Price $1,308.95 / $3,399.94 / $4,932.02	Facility		$1,308.95	$3,399.94	$4,932.02
Prevea360 Facility/Professional Professional Modifier Low / Median / High Price $2,737.67 / $2,737.67 / $4,945.08	Professional		$2,737.67	$2,737.67	$4,945.08
Quartz Facility/Professional Professional Modifier Low / Median / High Price $462.79 / $969.44 / $1,258.74	Professional		$462.79	$969.44	$1,258.74
Quartz Facility/Professional Facility Modifier Low / Median / High Price $2,399.94 / $7,830.24 / $21,753.30	Facility		$2,399.94	$7,830.24	$21,753.30
Quartz Facility/Professional Professional Modifier Low / Median / High Price $326.16 / $2,399.94 / $2,399.94	Professional		$326.16	$2,399.94	$2,399.94
United Facility/Professional Professional Modifier Low / Median / High Price $1,641.70 / $2,278.92 / $4,915.85	Professional		$1,641.70	$2,278.92	$4,915.85