Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $376.21 / $376.21 / $17,823.00	Facility		$376.21	$376.21	$17,823.00
Aetna Facility/Professional Professional Modifier Low / Median / High Price $172.44 / $376.21 / $958.54	Professional		$172.44	$376.21	$958.54
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $4,637.00 / $7,653.00 / $11,863.00	Facility		$4,637.00	$7,653.00	$11,863.00
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $615.49 / $1,397.54 / $4,314.35	Professional		$615.49	$1,397.54	$4,314.35
Cigna Facility/Professional Facility Modifier Low / Median / High Price $13,989.89 / $16,348.29 / $26,369.21	Facility		$13,989.89	$16,348.29	$26,369.21
Cigna Facility/Professional Professional Modifier Low / Median / High Price $2,482.17 / $2,820.66 / $7,277.34	Professional		$2,482.17	$2,820.66	$7,277.34
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $376.21 / $805.68 / $6,683.74	Facility		$376.21	$805.68	$6,683.74
Medica Facility/Professional Facility Modifier Low / Median / High Price $612.94 / $3,583.00 / $9,547.50	Facility		$612.94	$3,583.00	$9,547.50
Medica Facility/Professional Professional Modifier Low / Median / High Price $1,699.80 / $11,056.50 / $27,168.30	Professional		$1,699.80	$11,056.50	$27,168.30
Molina Facility/Professional Professional Modifier Low / Median / High Price $58.40 / $2,493.01 / $13,202.10	Professional		$58.40	$2,493.01	$13,202.10
Prevea360 Facility/Professional Facility Modifier Low / Median / High Price $376.21 / $805.68 / $6,683.74	Facility		$376.21	$805.68	$6,683.74
Quartz Facility/Professional Professional Modifier Low / Median / High Price $806.73 / $1,480.58 / $2,131.52	Professional		$806.73	$1,480.58	$2,131.52
Quartz Facility/Professional Facility Modifier Low / Median / High Price $5,439.31 / $5,439.31 / $5,439.31	Facility		$5,439.31	$5,439.31	$5,439.31
Quartz Facility/Professional Professional Modifier Low / Median / High Price $2,567.66 / $7,345.05 / $7,345.05	Professional		$2,567.66	$7,345.05	$7,345.05
United Facility/Professional Facility Modifier Low / Median / High Price $2,203.00 / $4,316.80 / $19,003.00	Facility		$2,203.00	$4,316.80	$19,003.00
United Facility/Professional Professional Modifier Low / Median / High Price $718.08 / $11,363.47 / $28,505.69	Professional		$718.08	$11,363.47	$28,505.69