Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $889.51 / $889.51 / $14,482.00	Facility		$889.51	$889.51	$14,482.00
Aetna Facility/Professional Professional Modifier Low / Median / High Price $889.51 / $1,059.20 / $1,455.89	Professional		$889.51	$1,059.20	$1,455.89
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $5,692.00 / $15,738.00 / $23,778.77	Facility		$5,692.00	$15,738.00	$23,778.77
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $1,379.73 / $2,326.41 / $5,437.92	Professional		$1,379.73	$2,326.41	$5,437.92
Cigna Facility/Professional Facility Modifier Low / Median / High Price $4,035.22 / $4,715.47 / $7,605.88	Facility		$4,035.22	$4,715.47	$7,605.88
Cigna Facility/Professional Professional Modifier Low / Median / High Price $1,699.88 / $2,557.27 / $2,905.99	Professional		$1,699.88	$2,557.27	$2,905.99
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $1,040.73 / $1,799.38 / $2,709.09	Facility		$1,040.73	$1,799.38	$2,709.09
Medica Facility/Professional Facility Modifier Low / Median / High Price $1,473.01 / $11,256.00 / $26,727.00	Facility		$1,473.01	$11,256.00	$26,727.00
Medica Facility/Professional Professional Modifier Low / Median / High Price $1,499.48 / $2,871.88 / $10,101.84	Professional		$1,499.48	$2,871.88	$10,101.84
Molina Facility/Professional Professional Modifier Low / Median / High Price $55.00 / $65.00 / $2,941.35	Professional		$55.00	$65.00	$2,941.35
Prevea360 Facility/Professional Facility Modifier Low / Median / High Price $1,040.73 / $1,799.38 / $3,163.73	Facility		$1,040.73	$1,799.38	$3,163.73
Quartz Facility/Professional Professional Modifier Low / Median / High Price $2,191.86 / $3,201.74 / $4,391.03	Professional		$2,191.86	$3,201.74	$4,391.03
Quartz Facility/Professional Facility Modifier Low / Median / High Price $102,618.25 / $102,618.25 / $102,618.25	Facility		$102,618.25	$102,618.25	$102,618.25
Quartz Facility/Professional Professional Modifier Low / Median / High Price $6,071.94 / $6,940.05 / $10,796.72	Professional		$6,071.94	$6,940.05	$10,796.72
Security Health Facility/Professional Professional Modifier Low / Median / High Price $7,392.00 / $7,392.00 / $7,392.00	Professional		$7,392.00	$7,392.00	$7,392.00
Security Health Facility/Professional Professional Modifier Low / Median / High Price $9,544.79 / $15,672.56 / $15,672.56	Professional		$9,544.79	$15,672.56	$15,672.56
United Facility/Professional Facility Modifier Low / Median / High Price $11,078.00 / $19,708.00 / $24,111.00	Facility		$11,078.00	$19,708.00	$24,111.00
United Facility/Professional Professional Modifier Low / Median / High Price $1,499.48 / $2,807.56 / $6,340.29	Professional		$1,499.48	$2,807.56	$6,340.29