Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $1,045.08 / $2,548.35 / $14,482.00	Facility		$1,045.08	$2,548.35	$14,482.00
Aetna Facility/Professional Facility Modifier 52 Low / Median / High Price $522.54 / $1,274.18 / $2,270.87	Facility	52	$522.54	$1,274.18	$2,270.87
Aetna Facility/Professional Professional Modifier Low / Median / High Price $1,045.08 / $1,199.25 / $2,548.35	Professional		$1,045.08	$1,199.25	$2,548.35
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $5,060.00 / $7,344.00 / $10,517.23	Facility		$5,060.00	$7,344.00	$10,517.23
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $1,174.25 / $2,794.54 / $5,877.95	Professional		$1,174.25	$2,794.54	$5,877.95
Cigna Facility/Professional Facility Modifier Low / Median / High Price $3,225.11 / $3,768.79 / $5,781.43	Facility		$3,225.11	$3,768.79	$5,781.43
Cigna Facility/Professional Professional Modifier Low / Median / High Price $1,309.47 / $2,265.19 / $3,611.19	Professional		$1,309.47	$2,265.19	$3,611.19
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $1,132.59 / $1,752.76 / $3,627.15	Facility		$1,132.59	$1,752.76	$3,627.15
Medica Facility/Professional Facility Modifier Low / Median / High Price $1,222.74 / $3,399.93 / $11,598.00	Facility		$1,222.74	$3,399.93	$11,598.00
Medica Facility/Professional Facility Modifier 52 Low / Median / High Price $8,418.48 / $8,418.48 / $8,418.48	Facility	52	$8,418.48	$8,418.48	$8,418.48
Medica Facility/Professional Facility Modifier AS Low / Median / High Price $1,052.31 / $1,052.31 / $1,052.31	Facility	AS	$1,052.31	$1,052.31	$1,052.31
Medica Facility/Professional Professional Modifier Low / Median / High Price $1,340.26 / $2,460.31 / $6,007.73	Professional		$1,340.26	$2,460.31	$6,007.73
Molina Facility/Professional Professional Modifier Low / Median / High Price $125.82 / $748.84 / $2,224.32	Professional		$125.82	$748.84	$2,224.32
Prevea360 Facility/Professional Facility Modifier Low / Median / High Price $1,132.59 / $1,752.76 / $3,627.15	Facility		$1,132.59	$1,752.76	$3,627.15
Quartz Facility/Professional Professional Modifier Low / Median / High Price $2,379.07 / $3,050.36 / $4,328.91	Professional		$2,379.07	$3,050.36	$4,328.91
Quartz Facility/Professional Facility Modifier Low / Median / High Price $7,529.08 / $11,102.00 / $11,102.00	Facility		$7,529.08	$11,102.00	$11,102.00
Quartz Facility/Professional Facility Modifier 52 Low / Median / High Price $6,023.26 / $8,418.48 / $8,418.48	Facility	52	$6,023.26	$8,418.48	$8,418.48
Quartz Facility/Professional Facility Modifier AS Low / Median / High Price $752.91 / $1,052.31 / $1,052.31	Facility	AS	$752.91	$1,052.31	$1,052.31
Quartz Facility/Professional Professional Modifier Low / Median / High Price $1,439.37 / $5,223.51 / $9,294.87	Professional		$1,439.37	$5,223.51	$9,294.87
Security Health Facility/Professional Professional Modifier Low / Median / High Price $2,246.19 / $3,180.51 / $5,284.44	Professional		$2,246.19	$3,180.51	$5,284.44
United Facility/Professional Facility Modifier Low / Median / High Price $6,073.00 / $9,837.00 / $12,062.00	Facility		$6,073.00	$9,837.00	$12,062.00
United Facility/Professional Professional Modifier Low / Median / High Price $1,227.73 / $2,412.56 / $4,701.85	Professional		$1,227.73	$2,412.56	$4,701.85