Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $1,198.32 / $1,198.32 / $17,823.00	Facility		$1,198.32	$1,198.32	$17,823.00
Aetna Facility/Professional Professional Modifier Low / Median / High Price $1,198.32 / $1,961.31 / $12,619.52	Professional		$1,198.32	$1,961.31	$12,619.52
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $12,080.00 / $17,505.00 / $23,937.00	Facility		$12,080.00	$17,505.00	$23,937.00
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $1,275.43 / $3,366.29 / $8,981.70	Professional		$1,275.43	$3,366.29	$8,981.70
Cigna Facility/Professional Professional Modifier Low / Median / High Price $2,276.41 / $2,276.41 / $2,586.83	Professional		$2,276.41	$2,276.41	$2,586.83
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $1,198.32 / $2,574.42 / $15,622.31	Facility		$1,198.32	$2,574.42	$15,622.31
Medica Facility/Professional Facility Modifier Low / Median / High Price $1,815.13 / $4,602.00 / $15,622.31	Facility		$1,815.13	$4,602.00	$15,622.31
Medica Facility/Professional Professional Modifier Low / Median / High Price $1,526.58 / $3,887.37 / $7,564.59	Professional		$1,526.58	$3,887.37	$7,564.59
Molina Facility/Professional Professional Modifier Low / Median / High Price $50.00 / $58.40 / $4,722.16	Professional		$50.00	$58.40	$4,722.16
Prevea360 Facility/Professional Facility Modifier Low / Median / High Price $1,198.32 / $2,574.42 / $15,622.31	Facility		$1,198.32	$2,574.42	$15,622.31
Quartz Facility/Professional Professional Modifier Low / Median / High Price $4,912.60 / $19,375.29 / $27,019.30	Professional		$4,912.60	$19,375.29	$27,019.30
Quartz Facility/Professional Facility Modifier Low / Median / High Price $37,183.86 / $37,183.86 / $37,183.86	Facility		$37,183.86	$37,183.86	$37,183.86
Quartz Facility/Professional Professional Modifier Low / Median / High Price $27,971.64 / $44,281.65 / $44,281.65	Professional		$27,971.64	$44,281.65	$44,281.65
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 $1,526.58 / $4,569.13 / $7,564.59	Professional		$1,526.58	$4,569.13	$7,564.59