Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $3,735.90 / $3,735.90 / $3,735.90	Facility		$3,735.90	$3,735.90	$3,735.90
Aetna Facility/Professional Professional Modifier Low / Median / High Price $2,349.16 / $3,362.31 / $4,408.29	Professional		$2,349.16	$3,362.31	$4,408.29
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $4,923.50 / $8,960.77 / $8,960.77	Facility		$4,923.50	$8,960.77	$8,960.77
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $2,945.98 / $4,578.85 / $6,154.37	Professional		$2,945.98	$4,578.85	$6,154.37
CareSource Facility/Professional Facility Modifier Low / Median / High Price $347.10 / $347.10 / $1,053.63	Facility		$347.10	$347.10	$1,053.63
Cigna Facility/Professional Facility Modifier Low / Median / High Price $2,643.20 / $3,621.85 / $13,156.35	Facility		$2,643.20	$3,621.85	$13,156.35
Cigna Facility/Professional Professional Modifier Low / Median / High Price $3,078.57 / $5,707.50 / $7,134.38	Professional		$3,078.57	$5,707.50	$7,134.38
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $2,625.86 / $3,735.90 / $5,603.85	Facility		$2,625.86	$3,735.90	$5,603.85
DeanCare Facility/Professional Professional Modifier Low / Median / High Price $345.49 / $345.49 / $3,938.80	Professional		$345.49	$345.49	$3,938.80
Medica Facility/Professional Facility Modifier Low / Median / High Price $367.08 / $3,735.90 / $5,237.12	Facility		$367.08	$3,735.90	$5,237.12
Medica Facility/Professional Professional Modifier Low / Median / High Price $1,543.50 / $2,469.60 / $4,736.41	Professional		$1,543.50	$2,469.60	$4,736.41
Molina Facility/Professional Professional Modifier Low / Median / High Price $12.30 / $55.00 / $3,282.33	Professional		$12.30	$55.00	$3,282.33
Prevea360 Facility/Professional Facility Modifier Low / Median / High Price $2,625.86 / $3,735.90 / $5,603.85	Facility		$2,625.86	$3,735.90	$5,603.85
Prevea360 Facility/Professional Professional Modifier Low / Median / High Price $345.49 / $345.49 / $3,938.80	Professional		$345.49	$345.49	$3,938.80
Quartz Facility/Professional Professional Modifier Low / Median / High Price $549.71 / $1,151.65 / $1,495.33	Professional		$549.71	$1,151.65	$1,495.33
Quartz Facility/Professional Facility Modifier Low / Median / High Price $65.00 / $2,643.20 / $5,237.12	Facility		$65.00	$2,643.20	$5,237.12
Quartz Facility/Professional Professional Modifier Low / Median / High Price $386.96 / $3,621.85 / $3,621.85	Professional		$386.96	$3,621.85	$3,621.85
United Facility/Professional Professional Modifier Low / Median / High Price $1,510.76 / $2,418.12 / $4,630.50	Professional		$1,510.76	$2,418.12	$4,630.50