Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $3,764.95 / $3,764.95 / $3,764.95	Facility		$3,764.95	$3,764.95	$3,764.95
Aetna Facility/Professional Professional Modifier Low / Median / High Price $2,367.39 / $3,388.46 / $4,442.49	Professional		$2,367.39	$3,388.46	$4,442.49
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $4,974.00 / $9,052.68 / $9,052.68	Facility		$4,974.00	$9,052.68	$9,052.68
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $2,976.17 / $4,625.82 / $6,118.02	Professional		$2,976.17	$4,625.82	$6,118.02
CareSource Facility/Professional Facility Modifier Low / Median / High Price $350.65 / $350.65 / $1,064.44	Facility		$350.65	$350.65	$1,064.44
Cigna Facility/Professional Facility Modifier Low / Median / High Price $2,658.56 / $3,657.49 / $13,291.52	Facility		$2,658.56	$3,657.49	$13,291.52
Cigna Facility/Professional Professional Modifier Low / Median / High Price $3,108.87 / $5,767.50 / $7,209.38	Professional		$3,108.87	$5,767.50	$7,209.38
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $2,652.80 / $3,764.95 / $5,647.43	Facility		$2,652.80	$3,764.95	$5,647.43
DeanCare Facility/Professional Professional Modifier Low / Median / High Price $346.58 / $346.58 / $3,979.20	Professional		$346.58	$346.58	$3,979.20
Medica Facility/Professional Facility Modifier Low / Median / High Price $371.64 / $3,764.95 / $5,253.74	Facility		$371.64	$3,764.95	$5,253.74
Medica Facility/Professional Professional Modifier Low / Median / High Price $1,555.47 / $2,486.67 / $4,666.39	Professional		$1,555.47	$2,486.67	$4,666.39
Molina Facility/Professional Professional Modifier Low / Median / High Price $12.43 / $55.00 / $3,316.00	Professional		$12.43	$55.00	$3,316.00
Prevea360 Facility/Professional Facility Modifier Low / Median / High Price $2,652.80 / $3,764.95 / $5,647.43	Facility		$2,652.80	$3,764.95	$5,647.43
Prevea360 Facility/Professional Professional Modifier Low / Median / High Price $346.58 / $346.58 / $3,979.20	Professional		$346.58	$346.58	$3,979.20
Quartz Facility/Professional Professional Modifier Low / Median / High Price $555.36 / $1,163.48 / $1,510.70	Professional		$555.36	$1,163.48	$1,510.70
Quartz Facility/Professional Facility Modifier Low / Median / High Price $65.00 / $2,658.56 / $5,253.74	Facility		$65.00	$2,658.56	$5,253.74
Quartz Facility/Professional Professional Modifier Low / Median / High Price $390.93 / $3,657.49 / $3,657.49	Professional		$390.93	$3,657.49	$3,657.49
United Facility/Professional Professional Modifier Low / Median / High Price $1,498.14 / $2,425.67 / $4,507.58	Professional		$1,498.14	$2,425.67	$4,507.58