Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $717.58 / $717.58 / $14,482.00	Facility		$717.58	$717.58	$14,482.00
Aetna Facility/Professional Professional Modifier Low / Median / High Price $717.58 / $793.84 / $1,368.77	Professional		$717.58	$793.84	$1,368.77
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $11,499.00 / $15,923.00 / $22,428.00	Facility		$11,499.00	$15,923.00	$22,428.00
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $1,166.94 / $2,649.51 / $7,630.68	Professional		$1,166.94	$2,649.51	$7,630.68
Cigna Facility/Professional Facility Modifier Low / Median / High Price $9,143.35 / $9,143.35 / $9,143.35	Facility		$9,143.35	$9,143.35	$9,143.35
Cigna Facility/Professional Professional Modifier Low / Median / High Price $1,598.28 / $5,153.09 / $5,153.09	Professional		$1,598.28	$5,153.09	$5,153.09
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $717.58 / $1,086.96 / $1,793.95	Facility		$717.58	$1,086.96	$1,793.95
Medica Facility/Professional Facility Modifier Low / Median / High Price $741.83 / $1,376.06 / $16,779.00	Facility		$741.83	$1,376.06	$16,779.00
Medica Facility/Professional Professional Modifier Low / Median / High Price $1,389.69 / $2,367.94 / $8,706.79	Professional		$1,389.69	$2,367.94	$8,706.79
Molina Facility/Professional Professional Modifier Low / Median / High Price $50.00 / $58.40 / $70.00	Professional		$50.00	$58.40	$70.00
Prevea360 Facility/Professional Facility Modifier Low / Median / High Price $717.58 / $1,086.96 / $1,793.95	Facility		$717.58	$1,086.96	$1,793.95
Quartz Facility/Professional Professional Modifier Low / Median / High Price $2,146.80 / $2,759.71 / $3,935.80	Professional		$2,146.80	$2,759.71	$3,935.80
Quartz Facility/Professional Facility Modifier Low / Median / High Price $9,143.35 / $9,143.35 / $25,239.65	Facility		$9,143.35	$9,143.35	$25,239.65
Quartz Facility/Professional Professional Modifier Low / Median / High Price $4,896.68 / $5,153.09 / $8,706.79	Professional		$4,896.68	$5,153.09	$8,706.79
United Facility/Professional Facility Modifier Low / Median / High Price $6,154.00 / $12,373.00 / $17,327.00	Facility		$6,154.00	$12,373.00	$17,327.00
United Facility/Professional Professional Modifier Low / Median / High Price $1,371.47 / $2,471.96 / $5,590.05	Professional		$1,371.47	$2,471.96	$5,590.05