Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $6,837.60 / $6,837.60 / $6,837.60	Facility		$6,837.60	$6,837.60	$6,837.60
Aetna Facility/Professional Professional Modifier Low / Median / High Price $4,317.80 / $6,153.84 / $8,087.58	Professional		$4,317.80	$6,153.84	$8,087.58
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $10,262.50 / $18,677.75 / $18,677.75	Facility		$10,262.50	$18,677.75	$18,677.75
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $8,456.90 / $9,544.12 / $12,828.12	Professional		$8,456.90	$9,544.12	$12,828.12
CareSource Facility/Professional Facility Modifier Low / Median / High Price $738.27 / $738.27 / $2,196.17	Facility		$738.27	$738.27	$2,196.17
Cigna Facility/Professional Facility Modifier Low / Median / High Price $4,488.00 / $4,978.93 / $27,583.28	Facility		$4,488.00	$4,978.93	$27,583.28
Cigna Facility/Professional Professional Modifier Low / Median / High Price $4,232.09 / $11,898.75 / $14,873.44	Professional		$4,232.09	$11,898.75	$14,873.44
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $3,863.36 / $6,837.60 / $10,256.40	Facility		$3,863.36	$6,837.60	$10,256.40
DeanCare Facility/Professional Professional Modifier Low / Median / High Price $504.62 / $504.62 / $8,210.00	Professional		$504.62	$504.62	$8,210.00
Medica Facility/Professional Facility Modifier Low / Median / High Price $614.19 / $6,841.67 / $8,210.00	Facility		$614.19	$6,841.67	$8,210.00
Medica Facility/Professional Professional Modifier Low / Median / High Price $2,901.24 / $4,200.72 / $7,620.11	Professional		$2,901.24	$4,200.72	$7,620.11
Molina Facility/Professional Professional Modifier Low / Median / High Price $25.65 / $55.00 / $6,841.67	Professional		$25.65	$55.00	$6,841.67
Prevea360 Facility/Professional Facility Modifier Low / Median / High Price $3,863.36 / $6,837.60 / $10,256.40	Facility		$3,863.36	$6,837.60	$10,256.40
Prevea360 Facility/Professional Professional Modifier Low / Median / High Price $504.62 / $504.62 / $8,210.00	Professional		$504.62	$504.62	$8,210.00
Quartz Facility/Professional Professional Modifier Low / Median / High Price $1,152.53 / $2,052.46 / $2,664.97	Professional		$1,152.53	$2,052.46	$2,664.97
Quartz Facility/Professional Facility Modifier Low / Median / High Price $65.00 / $4,978.93 / $6,889.88	Facility		$65.00	$4,978.93	$6,889.88
Quartz Facility/Professional Professional Modifier Low / Median / High Price $725.31 / $4,488.00 / $4,978.93	Professional		$725.31	$4,488.00	$4,978.93
United Facility/Professional Professional Modifier Low / Median / High Price $2,591.55 / $4,097.68 / $7,253.10	Professional		$2,591.55	$4,097.68	$7,253.10