Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $1,106.88 / $1,106.88 / $17,823.00	Facility		$1,106.88	$1,106.88	$17,823.00
Aetna Facility/Professional Professional Modifier Low / Median / High Price $1,106.88 / $1,761.67 / $3,006.37	Professional		$1,106.88	$1,761.67	$3,006.37
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $10,878.00 / $11,302.00 / $14,586.00	Facility		$10,878.00	$11,302.00	$14,586.00
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $1,800.12 / $4,784.06 / $10,192.90	Professional		$1,800.12	$4,784.06	$10,192.90
Cigna Facility/Professional Facility Modifier Low / Median / High Price $16,124.64 / $18,842.91 / $30,392.96	Facility		$16,124.64	$18,842.91	$30,392.96
Cigna Facility/Professional Professional Modifier Low / Median / High Price $5,115.10 / $7,112.87 / $8,522.02	Professional		$5,115.10	$7,112.87	$8,522.02
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $1,106.88 / $1,636.56 / $2,748.90	Facility		$1,106.88	$1,636.56	$2,748.90
DeanCare Facility/Professional Professional Modifier Low / Median / High Price $1,278.56 / $1,278.56 / $1,396.40	Professional		$1,278.56	$1,278.56	$1,396.40
Medica Facility/Professional Facility Modifier Low / Median / High Price $1,295.05 / $5,558.00 / $8,783.00	Facility		$1,295.05	$5,558.00	$8,783.00
Medica Facility/Professional Professional Modifier Low / Median / High Price $2,096.55 / $4,543.89 / $8,539.87	Professional		$2,096.55	$4,543.89	$8,539.87
Molina Facility/Professional Professional Modifier Low / Median / High Price $50.00 / $50.00 / $70.00	Professional		$50.00	$50.00	$70.00
Prevea360 Facility/Professional Facility Modifier Low / Median / High Price $1,106.88 / $1,636.56 / $2,748.90	Facility		$1,106.88	$1,636.56	$2,748.90
Prevea360 Facility/Professional Professional Modifier Low / Median / High Price $1,278.56 / $1,278.56 / $1,396.40	Professional		$1,278.56	$1,278.56	$1,396.40
Quartz Facility/Professional Professional Modifier Low / Median / High Price $1,523.64 / $2,796.30 / $4,162.97	Professional		$1,523.64	$2,796.30	$4,162.97
Quartz Facility/Professional Facility Modifier Low / Median / High Price $14,590.64 / $14,590.64 / $14,590.64	Facility		$14,590.64	$14,590.64	$14,590.64
Quartz Facility/Professional Professional Modifier Low / Median / High Price $6,447.51 / $11,582.87 / $11,582.87	Professional		$6,447.51	$11,582.87	$11,582.87
United Facility/Professional Facility Modifier Low / Median / High Price $4,918.00 / $6,477.00 / $8,384.00	Facility		$4,918.00	$6,477.00	$8,384.00
United Facility/Professional Professional Modifier Low / Median / High Price $1,826.66 / $4,543.89 / $7,965.46	Professional		$1,826.66	$4,543.89	$7,965.46