Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $10,958.08 / $10,958.08 / $10,958.08	Facility		$10,958.08	$10,958.08	$10,958.08
Aetna Facility/Professional Professional Modifier Low / Median / High Price $6,919.86 / $9,862.27 / $12,961.35	Professional		$6,919.86	$9,862.27	$12,961.35
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $16,446.90 / $29,933.36 / $29,933.36	Facility		$16,446.90	$29,933.36	$29,933.36
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $8,071.90 / $15,295.62 / $20,558.62	Professional		$8,071.90	$15,295.62	$20,558.62
CareSource Facility/Professional Facility Modifier Low / Median / High Price $1,183.19 / $1,183.19 / $3,519.64	Facility		$1,183.19	$1,183.19	$3,519.64
Cigna Facility/Professional Facility Modifier Low / Median / High Price $10,102.62 / $10,102.62 / $50,227.20	Facility		$10,102.62	$10,102.62	$50,227.20
Cigna Facility/Professional Professional Modifier Low / Median / High Price $8,587.24 / $19,068.75 / $23,835.94	Professional		$8,587.24	$19,068.75	$23,835.94
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $6,191.44 / $10,958.08 / $16,437.12	Facility		$6,191.44	$10,958.08	$16,437.12
DeanCare Facility/Professional Professional Modifier Low / Median / High Price $728.41 / $728.41 / $13,157.53	Professional		$728.41	$728.41	$13,157.53
Medica Facility/Professional Facility Modifier Low / Median / High Price $80.00 / $10,964.61 / $16,437.12	Facility		$80.00	$10,964.61	$16,437.12
Medica Facility/Professional Professional Modifier Low / Median / High Price $3,940.68 / $5,470.12 / $12,212.17	Professional		$3,940.68	$5,470.12	$12,212.17
Molina Facility/Professional Professional Modifier Low / Median / High Price $40.15 / $55.00 / $10,707.60	Professional		$40.15	$55.00	$10,707.60
Prevea360 Facility/Professional Facility Modifier Low / Median / High Price $6,191.44 / $10,958.08 / $16,437.12	Facility		$6,191.44	$10,958.08	$16,437.12
Prevea360 Facility/Professional Professional Modifier Low / Median / High Price $728.41 / $728.41 / $13,157.53	Professional		$728.41	$728.41	$13,157.53
Quartz Facility/Professional Professional Modifier Low / Median / High Price $1,847.06 / $3,288.51 / $4,269.89	Professional		$1,847.06	$3,288.51	$4,269.89
Quartz Facility/Professional Facility Modifier Low / Median / High Price $65.00 / $10,102.62 / $11,041.73	Facility		$65.00	$10,102.62	$11,041.73
Quartz Facility/Professional Professional Modifier Low / Median / High Price $1,162.40 / $10,102.62 / $10,102.62	Professional		$1,162.40	$10,102.62	$10,102.62
United Facility/Professional Professional Modifier Low / Median / High Price $3,874.67 / $5,470.12 / $10,964.60	Professional		$3,874.67	$5,470.12	$10,964.60