Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $2,188.62 / $2,188.62 / $14,482.00	Facility		$2,188.62	$2,188.62	$14,482.00
Aetna Facility/Professional Professional Modifier Low / Median / High Price $2,188.62 / $2,305.19 / $3,139.72	Professional		$2,188.62	$2,305.19	$3,139.72
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 $2,459.12 / $5,519.44 / $11,493.68	Professional		$2,459.12	$5,519.44	$11,493.68
Cigna Facility/Professional Facility Modifier Low / Median / High Price $6,774.62 / $7,916.68 / $12,144.39	Facility		$6,774.62	$7,916.68	$12,144.39
Cigna Facility/Professional Professional Modifier Low / Median / High Price $2,467.42 / $5,110.74 / $8,210.12	Professional		$2,467.42	$5,110.74	$8,210.12
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $2,188.62 / $3,962.01 / $7,625.67	Facility		$2,188.62	$3,962.01	$7,625.67
Medica Facility/Professional Facility Modifier Low / Median / High Price $2,458.82 / $7,130.88 / $11,598.00	Facility		$2,458.82	$7,130.88	$11,598.00
Medica Facility/Professional Professional Modifier Low / Median / High Price $2,488.55 / $4,088.46 / $11,980.74	Professional		$2,488.55	$4,088.46	$11,980.74
Molina Facility/Professional Professional Modifier Low / Median / High Price $65.00 / $85.00 / $4,043.82	Professional		$65.00	$85.00	$4,043.82
Prevea360 Facility/Professional Facility Modifier Low / Median / High Price $2,188.62 / $3,962.01 / $7,625.67	Facility		$2,188.62	$3,962.01	$7,625.67
Quartz Facility/Professional Professional Modifier Low / Median / High Price $4,822.20 / $6,365.30 / $8,886.14	Professional		$4,822.20	$6,365.30	$8,886.14
Quartz Facility/Professional Facility Modifier Low / Median / High Price $7,529.08 / $18,605.88 / $18,605.88	Facility		$7,529.08	$18,605.88	$18,605.88
Quartz Facility/Professional Professional Modifier Low / Median / High Price $3,020.70 / $10,962.23 / $22,595.87	Professional		$3,020.70	$10,962.23	$22,595.87
Security Health Facility/Professional Professional Modifier Low / Median / High Price $2,724.56 / $9,286.14 / $9,286.14	Professional		$2,724.56	$9,286.14	$9,286.14
United Facility/Professional Facility Modifier Low / Median / High Price $6,241.00 / $9,837.00 / $12,062.00	Facility		$6,241.00	$9,837.00	$12,062.00
United Facility/Professional Professional Modifier Low / Median / High Price $2,387.71 / $3,720.64 / $10,174.36	Professional		$2,387.71	$3,720.64	$10,174.36