Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $2,867.27 / $2,867.27 / $2,867.27	Facility		$2,867.27	$2,867.27	$2,867.27
Aetna Facility/Professional Professional Modifier Low / Median / High Price $1,778.14 / $2,623.70 / $3,421.26	Professional		$1,778.14	$2,623.70	$3,421.26
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $3,347.50 / $6,092.45 / $6,092.45	Facility		$3,347.50	$6,092.45	$6,092.45
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $2,359.94 / $3,113.18 / $4,117.42	Professional		$2,359.94	$3,113.18	$4,117.42
CareSource Facility/Professional Facility Modifier Low / Median / High Price $235.99 / $235.99 / $716.37	Facility		$235.99	$235.99	$716.37
Cigna Facility/Professional Facility Modifier Low / Median / High Price $2,290.69 / $2,290.69 / $3,236.31	Facility		$2,290.69	$2,290.69	$3,236.31
Cigna Facility/Professional Professional Modifier Low / Median / High Price $1,947.10 / $3,993.75 / $4,992.18	Professional		$1,947.10	$3,993.75	$4,992.18
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $273.61 / $2,736.08 / $4,300.91	Facility		$273.61	$2,736.08	$4,300.91
DeanCare Facility/Professional Professional Modifier Low / Median / High Price $321.89 / $321.89 / $401.70	Professional		$321.89	$321.89	$401.70
Medica Facility/Professional Facility Modifier Low / Median / High Price $273.61 / $2,867.27 / $4,879.47	Facility		$273.61	$2,867.27	$4,879.47
Medica Facility/Professional Professional Modifier Low / Median / High Price $1,385.32 / $2,253.04 / $3,948.50	Professional		$1,385.32	$2,253.04	$3,948.50
Molina Facility/Professional Professional Modifier Low / Median / High Price $6.57 / $55.00 / $1,795.69	Professional		$6.57	$55.00	$1,795.69
Prevea360 Facility/Professional Facility Modifier Low / Median / High Price $273.61 / $2,736.08 / $4,300.91	Facility		$273.61	$2,736.08	$4,300.91
Prevea360 Facility/Professional Professional Modifier Low / Median / High Price $321.89 / $321.89 / $401.70	Professional		$321.89	$321.89	$401.70
Quartz Facility/Professional Professional Modifier Low / Median / High Price $373.75 / $746.99 / $969.92	Professional		$373.75	$746.99	$969.92
Quartz Facility/Professional Facility Modifier Low / Median / High Price $80.00 / $3,877.69 / $4,879.47	Facility		$80.00	$3,877.69	$4,879.47
Quartz Facility/Professional Professional Modifier Low / Median / High Price $268.08 / $2,290.69 / $3,236.31	Professional		$268.08	$2,290.69	$3,236.31
United Facility/Professional Facility Modifier Low / Median / High Price $204.97 / $334.75 / $2,383.14	Facility		$204.97	$334.75	$2,383.14
United Facility/Professional Professional Modifier Low / Median / High Price $1,385.32 / $2,041.20 / $3,647.73	Professional		$1,385.32	$2,041.20	$3,647.73