Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $1,789.02 / $4,374.56 / $14,482.00	Facility		$1,789.02	$4,374.56	$14,482.00
Aetna Facility/Professional Professional Modifier Low / Median / High Price $1,638.57 / $1,878.08 / $7,442.79	Professional		$1,638.57	$1,878.08	$7,442.79
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $8,712.00 / $12,444.00 / $20,227.00	Facility		$8,712.00	$12,444.00	$20,227.00
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $2,106.33 / $5,358.60 / $9,994.68	Professional		$2,106.33	$5,358.60	$9,994.68
Cigna Facility/Professional Facility Modifier Low / Median / High Price $5,500.44 / $6,427.70 / $10,367.64	Facility		$5,500.44	$6,427.70	$10,367.64
Cigna Facility/Professional Professional Modifier Low / Median / High Price $3,888.49 / $5,427.37 / $8,823.39	Professional		$3,888.49	$5,427.37	$8,823.39
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $1,789.02 / $2,733.89 / $4,725.00	Facility		$1,789.02	$2,733.89	$4,725.00
Medica Facility/Professional Facility Modifier Low / Median / High Price $2,093.15 / $4,754.12 / $14,978.00	Facility		$2,093.15	$4,754.12	$14,978.00
Medica Facility/Professional Professional Modifier Low / Median / High Price $2,507.92 / $5,715.74 / $10,320.19	Professional		$2,507.92	$5,715.74	$10,320.19
Molina Facility/Professional Professional Modifier Low / Median / High Price $218.95 / $1,314.10 / $4,137.91	Professional		$218.95	$1,314.10	$4,137.91
Prevea360 Facility/Professional Facility Modifier Low / Median / High Price $1,789.02 / $2,733.89 / $4,725.00	Facility		$1,789.02	$2,733.89	$4,725.00
Quartz Facility/Professional Professional Modifier Low / Median / High Price $4,247.10 / $6,047.51 / $7,725.15	Professional		$4,247.10	$6,047.51	$7,725.15
Quartz Facility/Professional Facility Modifier Low / Median / High Price $15,086.58 / $15,086.58 / $15,086.58	Facility		$15,086.58	$15,086.58	$15,086.58
Quartz Facility/Professional Professional Modifier Low / Median / High Price $4,083.88 / $10,519.70 / $24,606.41	Professional		$4,083.88	$10,519.70	$24,606.41
Security Health Facility/Professional Professional Modifier Low / Median / High Price $3,951.85 / $3,951.85 / $3,951.85	Professional		$3,951.85	$3,951.85	$3,951.85
Security Health Facility/Professional Professional Modifier Low / Median / High Price $3,993.17 / $9,025.11 / $9,025.11	Professional		$3,993.17	$9,025.11	$9,025.11
United Facility/Professional Facility Modifier Low / Median / High Price $7,217.00 / $11,608.00 / $13,980.00	Facility		$7,217.00	$11,608.00	$13,980.00
United Facility/Professional Professional Modifier Low / Median / High Price $2,293.13 / $5,715.74 / $8,969.10	Professional		$2,293.13	$5,715.74	$8,969.10