Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $7,093.31 / $7,093.31 / $7,093.31	Facility		$7,093.31	$7,093.31	$7,093.31
Aetna Facility/Professional Professional Modifier Low / Median / High Price $4,479.30 / $6,383.98 / $8,390.07	Professional		$4,479.30	$6,383.98	$8,390.07
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $10,646.30 / $19,376.27 / $19,376.27	Facility		$10,646.30	$19,376.27	$19,376.27
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $5,225.00 / $9,901.06 / $13,094.94	Professional		$5,225.00	$9,901.06	$13,094.94
CareSource Facility/Professional Facility Modifier Low / Median / High Price $765.89 / $765.89 / $2,278.31	Facility		$765.89	$765.89	$2,278.31
Cigna Facility/Professional Facility Modifier Low / Median / High Price $5,145.60 / $6,539.60 / $28,610.56	Facility		$5,145.60	$6,539.60	$28,610.56
Cigna Facility/Professional Professional Modifier Low / Median / High Price $5,558.66 / $12,341.25 / $15,426.56	Professional		$5,558.66	$12,341.25	$15,426.56
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $4,007.68 / $7,093.31 / $10,639.97	Facility		$4,007.68	$7,093.31	$10,639.97
DeanCare Facility/Professional Professional Modifier Low / Median / High Price $471.50 / $471.50 / $8,517.04	Professional		$471.50	$471.50	$8,517.04
Medica Facility/Professional Facility Modifier Low / Median / High Price $80.00 / $7,097.54 / $10,639.97	Facility		$80.00	$7,097.54	$10,639.97
Medica Facility/Professional Professional Modifier Low / Median / High Price $2,550.83 / $3,540.88 / $7,905.14	Professional		$2,550.83	$3,540.88	$7,905.14
Molina Facility/Professional Professional Modifier Low / Median / High Price $26.61 / $55.00 / $7,097.53	Professional		$26.61	$55.00	$7,097.53
Prevea360 Facility/Professional Facility Modifier Low / Median / High Price $4,007.68 / $7,093.31 / $10,639.97	Facility		$4,007.68	$7,093.31	$10,639.97
Prevea360 Facility/Professional Professional Modifier Low / Median / High Price $471.50 / $471.50 / $8,517.04	Professional		$471.50	$471.50	$8,517.04
Quartz Facility/Professional Professional Modifier Low / Median / High Price $1,195.63 / $2,128.96 / $2,764.32	Professional		$1,195.63	$2,128.96	$2,764.32
Quartz Facility/Professional Facility Modifier Low / Median / High Price $65.00 / $5,145.60 / $7,147.29	Facility		$65.00	$5,145.60	$7,147.29
Quartz Facility/Professional Professional Modifier Low / Median / High Price $752.44 / $6,539.60 / $6,539.60	Professional		$752.44	$6,539.60	$6,539.60
United Facility/Professional Professional Modifier Low / Median / High Price $2,356.61 / $3,540.88 / $7,097.53	Professional		$2,356.61	$3,540.88	$7,097.53