Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $2,788.80 / $2,788.80 / $2,788.80	Facility		$2,788.80	$2,788.80	$2,788.80
Aetna Facility/Professional Professional Modifier Low / Median / High Price $1,800.38 / $2,686.82 / $3,378.33	Professional		$1,800.38	$2,686.82	$3,378.33
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $3,497.60 / $6,365.63 / $6,365.63	Facility		$3,497.60	$6,365.63	$6,365.63
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $2,852.72 / $3,252.77 / $4,302.04	Professional		$2,852.72	$3,252.77	$4,302.04
CareSource Facility/Professional Facility Modifier Low / Median / High Price $246.58 / $246.58 / $748.49	Facility		$246.58	$246.58	$748.49
Cigna Facility/Professional Facility Modifier Low / Median / High Price $2,434.80 / $2,671.66 / $10,407.94	Facility		$2,434.80	$2,671.66	$10,407.94
Cigna Facility/Professional Professional Modifier Low / Median / High Price $2,270.91 / $4,515.00 / $5,643.75	Professional		$2,270.91	$4,515.00	$5,643.75
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $239.11 / $419.71 / $4,183.20	Facility		$239.11	$419.71	$4,183.20
DeanCare Facility/Professional Professional Modifier Low / Median / High Price $281.30 / $281.30 / $419.71	Professional		$281.30	$281.30	$419.71
Medica Facility/Professional Facility Modifier Low / Median / High Price $80.00 / $566.74 / $4,264.28	Facility		$80.00	$566.74	$4,264.28
Medica Facility/Professional Professional Modifier Low / Median / High Price $1,217.25 / $1,968.76 / $3,535.67	Professional		$1,217.25	$1,968.76	$3,535.67
Molina Facility/Professional Professional Modifier Low / Median / High Price $6.09 / $55.00 / $1,665.25	Professional		$6.09	$55.00	$1,665.25
Prevea360 Facility/Professional Facility Modifier Low / Median / High Price $239.11 / $2,391.12 / $4,183.20	Facility		$239.11	$2,391.12	$4,183.20
Prevea360 Facility/Professional Professional Modifier Low / Median / High Price $281.30 / $281.30 / $419.71	Professional		$281.30	$281.30	$419.71
Quartz Facility/Professional Professional Modifier Low / Median / High Price $390.52 / $797.48 / $1,035.47	Professional		$390.52	$797.48	$1,035.47
Quartz Facility/Professional Facility Modifier Low / Median / High Price $65.00 / $2,434.80 / $4,264.28	Facility		$65.00	$2,434.80	$4,264.28
Quartz Facility/Professional Professional Modifier Low / Median / High Price $286.64 / $2,671.66 / $2,671.66	Professional		$286.64	$2,671.66	$2,671.66
United Facility/Professional Professional Modifier Low / Median / High Price $1,137.28 / $1,936.85 / $3,449.10	Professional		$1,137.28	$1,936.85	$3,449.10