Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $1,017.80 / $1,017.80 / $1,017.80	Facility		$1,017.80	$1,017.80	$1,017.80
Aetna Facility/Professional Professional Modifier Low / Median / High Price $639.63 / $916.02 / $1,200.59	Professional		$639.63	$916.02	$1,200.59
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $1,512.60 / $2,752.93 / $2,752.93	Facility		$1,512.60	$2,752.93	$2,752.93
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $1,189.97 / $1,406.72 / $1,860.49	Professional		$1,189.97	$1,406.72	$1,860.49
CareSource Facility/Professional Facility Modifier Low / Median / High Price $106.64 / $116.30 / $345.97	Facility		$106.64	$116.30	$345.97
Cigna Facility/Professional Facility Modifier Low / Median / High Price $642.26 / $642.26 / $4,046.03	Facility		$642.26	$642.26	$4,046.03
Cigna Facility/Professional Professional Modifier Low / Median / High Price $545.91 / $1,755.00 / $2,193.75	Professional		$545.91	$1,755.00	$2,193.75
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $912.74 / $1,506.03 / $1,815.12	Facility		$912.74	$1,506.03	$1,815.12
DeanCare Facility/Professional Professional Modifier Low / Median / High Price $1,073.82 / $1,073.82 / $1,815.12	Professional		$1,073.82	$1,073.82	$1,815.12
Medica Facility/Professional Facility Modifier Low / Median / High Price $912.74 / $1,526.70 / $8,276.54	Facility		$912.74	$1,526.70	$8,276.54
Medica Facility/Professional Professional Modifier Low / Median / High Price $674.03 / $919.13 / $1,890.60	Professional		$674.03	$919.13	$1,890.60
Molina Facility/Professional Professional Modifier Low / Median / High Price $50.00 / $58.40 / $65.00	Professional		$50.00	$58.40	$65.00
Prevea360 Facility/Professional Facility Modifier Low / Median / High Price $912.74 / $1,506.03 / $1,815.12	Facility		$912.74	$1,506.03	$1,815.12
Prevea360 Facility/Professional Professional Modifier Low / Median / High Price $1,073.82 / $1,073.82 / $1,815.12	Professional		$1,073.82	$1,073.82	$1,815.12
Quartz Facility/Professional Professional Modifier Low / Median / High Price $168.89 / $369.16 / $479.33	Professional		$168.89	$369.16	$479.33
Quartz Facility/Professional Facility Modifier Low / Median / High Price $642.26 / $2,144.56 / $8,276.54	Facility		$642.26	$2,144.56	$8,276.54
Quartz Facility/Professional Professional Modifier Low / Median / High Price $118.88 / $642.26 / $642.26	Professional		$118.88	$642.26	$642.26
United Facility/Professional Professional Modifier Low / Median / High Price $630.20 / $893.88 / $1,935.56	Professional		$630.20	$893.88	$1,935.56