Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $1,321.60 / $1,321.60 / $14,482.00	Facility		$1,321.60	$1,321.60	$14,482.00
Aetna Facility/Professional Professional Modifier Low / Median / High Price $1,321.60 / $1,803.91 / $2,498.57	Professional		$1,321.60	$1,803.91	$2,498.57
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $11,499.00 / $16,241.00 / $22,519.00	Facility		$11,499.00	$16,241.00	$22,519.00
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $2,162.35 / $4,879.77 / $14,879.81	Professional		$2,162.35	$4,879.77	$14,879.81
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $1,321.60 / $2,001.89 / $3,304.00	Facility		$1,321.60	$2,001.89	$3,304.00
Medica Facility/Professional Facility Modifier Low / Median / High Price $1,365.97 / $2,468.42 / $7,565.00	Facility		$1,365.97	$2,468.42	$7,565.00
Medica Facility/Professional Professional Modifier Low / Median / High Price $2,523.38 / $4,370.42 / $16,926.72	Professional		$2,523.38	$4,370.42	$16,926.72
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 $1,321.60 / $2,001.89 / $3,304.00	Facility		$1,321.60	$2,001.89	$3,304.00
Quartz Facility/Professional Professional Modifier Low / Median / High Price $3,755.16 / $5,485.32 / $7,649.40	Professional		$3,755.16	$5,485.32	$7,649.40
Quartz Facility/Professional Facility Modifier Low / Median / High Price $43,086.56 / $43,086.56 / $43,086.56	Facility		$43,086.56	$43,086.56	$43,086.56
Quartz Facility/Professional Professional Modifier Low / Median / High Price $9,519.44 / $16,926.72 / $16,926.72	Professional		$9,519.44	$16,926.72	$16,926.72
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 $2,497.60 / $4,396.02 / $9,920.96	Professional		$2,497.60	$4,396.02	$9,920.96