Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $2,950.22 / $2,950.22 / $2,950.22	Facility		$2,950.22	$2,950.22	$2,950.22
Aetna Facility/Professional Professional Modifier Low / Median / High Price $1,892.99 / $2,761.98 / $3,551.76	Professional		$1,892.99	$2,761.98	$3,551.76
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $3,531.20 / $6,426.78 / $6,426.78	Facility		$3,531.20	$6,426.78	$6,426.78
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $2,230.86 / $3,284.02 / $4,414.00	Professional		$2,230.86	$3,284.02	$4,414.00
CareSource Facility/Professional Facility Modifier Low / Median / High Price $248.94 / $248.94 / $755.68	Facility		$248.94	$248.94	$755.68
Cigna Facility/Professional Facility Modifier Low / Median / High Price $2,446.40 / $2,446.40 / $10,074.52	Facility		$2,446.40	$2,446.40	$10,074.52
Cigna Facility/Professional Professional Modifier Low / Median / High Price $2,079.44 / $4,372.50 / $5,465.63	Professional		$2,079.44	$4,372.50	$5,465.63
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $272.55 / $2,718.32 / $4,497.09	Facility		$272.55	$2,718.32	$4,497.09
DeanCare Facility/Professional Professional Modifier Low / Median / High Price $319.80 / $319.80 / $423.74	Professional		$319.80	$319.80	$423.74
Medica Facility/Professional Facility Modifier Low / Median / High Price $272.55 / $2,950.22 / $4,847.72	Facility		$272.55	$2,950.22	$4,847.72
Medica Facility/Professional Professional Modifier Low / Median / High Price $1,382.40 / $2,238.28 / $3,997.50	Professional		$1,382.40	$2,238.28	$3,997.50
Molina Facility/Professional Professional Modifier Low / Median / High Price $6.60 / $55.00 / $1,803.72	Professional		$6.60	$55.00	$1,803.72
Prevea360 Facility/Professional Facility Modifier Low / Median / High Price $272.55 / $2,718.32 / $4,497.09	Facility		$272.55	$2,718.32	$4,497.09
Prevea360 Facility/Professional Professional Modifier Low / Median / High Price $319.80 / $319.80 / $423.74	Professional		$319.80	$319.80	$423.74
Quartz Facility/Professional Professional Modifier Low / Median / High Price $394.25 / $799.05 / $1,037.51	Professional		$394.25	$799.05	$1,037.51
Quartz Facility/Professional Facility Modifier Low / Median / High Price $65.00 / $2,446.40 / $4,847.72	Facility		$65.00	$2,446.40	$4,847.72
Quartz Facility/Professional Professional Modifier Low / Median / High Price $286.94 / $2,446.40 / $2,446.40	Professional		$286.94	$2,446.40	$2,446.40
United Facility/Professional Professional Modifier Low / Median / High Price $1,055.64 / $1,951.46 / $3,771.02	Professional		$1,055.64	$1,951.46	$3,771.02