Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $2,303.63 / $2,303.63 / $2,303.63	Facility		$2,303.63	$2,303.63	$2,303.63
Aetna Facility/Professional Professional Modifier Low / Median / High Price $1,430.77 / $2,101.62 / $2,685.06	Professional		$1,430.77	$2,101.62	$2,685.06
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $3,188.30 / $5,802.71 / $5,802.71	Facility		$3,188.30	$5,802.71	$5,802.71
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $2,245.57 / $2,965.12 / $3,921.60	Professional		$2,245.57	$2,965.12	$3,921.60
CareSource Facility/Professional Facility Modifier Low / Median / High Price $224.77 / $224.77 / $682.30	Facility		$224.77	$224.77	$682.30
Cigna Facility/Professional Facility Modifier Low / Median / High Price $1,918.38 / $2,225.09 / $8,686.79	Facility		$1,918.38	$2,225.09	$8,686.79
Cigna Facility/Professional Professional Modifier Low / Median / High Price $1,891.33 / $3,768.75 / $4,710.93	Professional		$1,891.33	$3,768.75	$4,710.93
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $164.04 / $1,640.40 / $3,496.25	Facility		$164.04	$1,640.40	$3,496.25
DeanCare Facility/Professional Professional Modifier Low / Median / High Price $192.99 / $192.99 / $382.60	Professional		$192.99	$192.99	$382.60
Medica Facility/Professional Facility Modifier Low / Median / High Price $164.04 / $2,913.54 / $16,659.23	Facility		$164.04	$2,913.54	$16,659.23
Medica Facility/Professional Professional Modifier Low / Median / High Price $922.14 / $1,384.72 / $2,766.41	Professional		$922.14	$1,384.72	$2,766.41
Molina Facility/Professional Professional Modifier Low / Median / High Price $5.64 / $55.00 / $1,543.67	Professional		$5.64	$55.00	$1,543.67
Prevea360 Facility/Professional Facility Modifier Low / Median / High Price $164.04 / $1,689.61 / $3,496.25	Facility		$164.04	$1,689.61	$3,496.25
Prevea360 Facility/Professional Professional Modifier Low / Median / High Price $192.99 / $192.99 / $382.60	Professional		$192.99	$192.99	$382.60
Quartz Facility/Professional Professional Modifier Low / Median / High Price $355.97 / $742.26 / $963.77	Professional		$355.97	$742.26	$963.77
Quartz Facility/Professional Facility Modifier Low / Median / High Price $65.00 / $5,657.66 / $16,659.23	Facility		$65.00	$5,657.66	$16,659.23
Quartz Facility/Professional Professional Modifier Low / Median / High Price $246.17 / $2,225.09 / $2,225.09	Professional		$246.17	$2,225.09	$2,225.09
United Facility/Professional Professional Modifier Low / Median / High Price $886.78 / $1,350.72 / $2,607.13	Professional		$886.78	$1,350.72	$2,607.13