Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $807.87 / $807.87 / $17,823.00	Facility		$807.87	$807.87	$17,823.00
Aetna Facility/Professional Professional Modifier Low / Median / High Price $807.87 / $1,466.33 / $2,219.42	Professional		$807.87	$1,466.33	$2,219.42
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 $1,313.85 / $2,982.89 / $8,853.70	Professional		$1,313.85	$2,982.89	$8,853.70
Cigna Facility/Professional Facility Modifier Low / Median / High Price $3,588.26 / $4,193.17 / $6,763.43	Facility		$3,588.26	$4,193.17	$6,763.43
Cigna Facility/Professional Professional Modifier Low / Median / High Price $1,556.97 / $1,988.34 / $2,475.35	Professional		$1,556.97	$1,988.34	$2,475.35
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $807.87 / $1,506.62 / $2,746.13	Facility		$807.87	$1,506.62	$2,746.13
Medica Facility/Professional Facility Modifier Low / Median / High Price $1,405.00 / $2,803.00 / $7,868.00	Facility		$1,405.00	$2,803.00	$7,868.00
Medica Facility/Professional Professional Modifier Low / Median / High Price $1,590.67 / $4,469.63 / $7,684.38	Professional		$1,590.67	$4,469.63	$7,684.38
Molina Facility/Professional Professional Modifier Low / Median / High Price $50.00 / $58.40 / $5,118.47	Professional		$50.00	$58.40	$5,118.47
Prevea360 Facility/Professional Facility Modifier Low / Median / High Price $807.87 / $1,506.62 / $2,746.13	Facility		$807.87	$1,506.62	$2,746.13
Quartz Facility/Professional Professional Modifier Low / Median / High Price $1,856.74 / $3,407.62 / $4,752.00	Professional		$1,856.74	$3,407.62	$4,752.00
Quartz Facility/Professional Facility Modifier Low / Median / High Price $26,758.72 / $26,758.72 / $26,758.72	Facility		$26,758.72	$26,758.72	$26,758.72
Quartz Facility/Professional Professional Modifier Low / Median / High Price $5,911.97 / $10,512.16 / $10,512.16	Professional		$5,911.97	$10,512.16	$10,512.16
Security Health Facility/Professional Professional Modifier Low / Median / High Price $6,929.78 / $6,929.78 / $6,929.78	Professional		$6,929.78	$6,929.78	$6,929.78
Security Health Facility/Professional Professional Modifier Low / Median / High Price $9,630.62 / $9,630.62 / $9,630.62	Professional		$9,630.62	$9,630.62	$9,630.62
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 $1,577.23 / $4,409.77 / $6,451.74	Professional		$1,577.23	$4,409.77	$6,451.74