Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $1,288.25 / $1,288.25 / $17,782.79	Facility		$1,288.25	$1,288.25	$17,782.79
Aetna Facility/Professional Professional Modifier Low / Median / High Price $1,288.25 / $1,905.46 / $2,238.72	Professional		$1,288.25	$1,905.46	$2,238.72
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $12,882.50 / $18,197.01 / $30,199.52	Facility		$12,882.50	$18,197.01	$30,199.52
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $2,818.38 / $4,365.16 / $10,964.78	Professional		$2,818.38	$4,365.16	$10,964.78
Cigna Facility/Professional Facility Modifier Low / Median / High Price $18,620.87 / $18,620.87 / $18,620.87	Facility		$18,620.87	$18,620.87	$18,620.87
Cigna Facility/Professional Professional Modifier Low / Median / High Price $3,311.31 / $3,311.31 / $3,715.35	Professional		$3,311.31	$3,311.31	$3,715.35
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $1,288.25 / $2,754.23 / $4,897.79	Facility		$1,288.25	$2,754.23	$4,897.79
Medica Facility/Professional Facility Modifier Low / Median / High Price $2,454.71 / $4,073.80 / $9,549.93	Facility		$2,454.71	$4,073.80	$9,549.93
Medica Facility/Professional Professional Modifier Low / Median / High Price $2,344.23 / $3,715.35 / $10,715.19	Professional		$2,344.23	$3,715.35	$10,715.19
Molina Facility/Professional Professional Modifier Low / Median / High Price $50.12 / $50.12 / $70.79	Professional		$50.12	$50.12	$70.79
Quartz Facility/Professional Professional Modifier Low / Median / High Price $3,630.78 / $5,495.41 / $7,762.47	Professional		$3,630.78	$5,495.41	$7,762.47
Quartz Facility/Professional Facility Modifier Low / Median / High Price $6,025.60 / $6,025.60 / $29,512.09	Facility		$6,025.60	$6,025.60	$29,512.09
Quartz Facility/Professional Professional Modifier Low / Median / High Price $4,168.69 / $16,982.44 / $16,982.44	Professional		$4,168.69	$16,982.44	$16,982.44
United Facility/Professional Facility Modifier Low / Median / High Price $2,290.87 / $6,165.95 / $19,498.45	Facility		$2,290.87	$6,165.95	$19,498.45
United Facility/Professional Professional Modifier Low / Median / High Price $2,238.72 / $3,630.78 / $8,511.38	Professional		$2,238.72	$3,630.78	$8,511.38