Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $3,739.40 / $3,739.40 / $3,739.40	Facility		$3,739.40	$3,739.40	$3,739.40
Aetna Facility/Professional Professional Modifier Low / Median / High Price $2,351.33 / $3,365.46 / $4,412.43	Professional		$2,351.33	$3,365.46	$4,412.43
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $4,930.60 / $8,973.69 / $8,973.69	Facility		$4,930.60	$8,973.69	$8,973.69
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $2,950.27 / $4,585.46 / $6,163.25	Professional		$2,950.27	$4,585.46	$6,163.25
CareSource Facility/Professional Facility Modifier Low / Median / High Price $347.60 / $347.60 / $1,055.15	Facility		$347.60	$347.60	$1,055.15
Cigna Facility/Professional Facility Modifier Low / Median / High Price $2,644.69 / $3,626.76 / $13,174.37	Facility		$2,644.69	$3,626.76	$13,174.37
Cigna Facility/Professional Professional Modifier Low / Median / High Price $3,082.75 / $5,715.00 / $7,143.75	Professional		$3,082.75	$5,715.00	$7,143.75
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $2,629.66 / $3,739.40 / $5,609.10	Facility		$2,629.66	$3,739.40	$5,609.10
DeanCare Facility/Professional Professional Modifier Low / Median / High Price $345.49 / $345.49 / $3,944.48	Professional		$345.49	$345.49	$3,944.48
Medica Facility/Professional Facility Modifier Low / Median / High Price $367.08 / $3,739.40 / $5,237.12	Facility		$367.08	$3,739.40	$5,237.12
Medica Facility/Professional Professional Modifier Low / Median / High Price $1,544.94 / $2,471.90 / $4,740.84	Professional		$1,544.94	$2,471.90	$4,740.84
Molina Facility/Professional Professional Modifier Low / Median / High Price $12.33 / $55.00 / $3,287.07	Professional		$12.33	$55.00	$3,287.07
Prevea360 Facility/Professional Facility Modifier Low / Median / High Price $2,629.66 / $3,739.40 / $5,609.10	Facility		$2,629.66	$3,739.40	$5,609.10
Prevea360 Facility/Professional Professional Modifier Low / Median / High Price $345.49 / $345.49 / $3,944.48	Professional		$345.49	$345.49	$3,944.48
Quartz Facility/Professional Professional Modifier Low / Median / High Price $550.51 / $1,153.23 / $1,497.38	Professional		$550.51	$1,153.23	$1,497.38
Quartz Facility/Professional Facility Modifier Low / Median / High Price $65.00 / $2,644.69 / $5,237.12	Facility		$65.00	$2,644.69	$5,237.12
Quartz Facility/Professional Professional Modifier Low / Median / High Price $387.52 / $3,626.76 / $3,626.76	Professional		$387.52	$3,626.76	$3,626.76
United Facility/Professional Professional Modifier Low / Median / High Price $1,512.96 / $2,418.12 / $4,634.81	Professional		$1,512.96	$2,418.12	$4,634.81