Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $2,554.73 / $5,385.73 / $14,482.00	Facility		$2,554.73	$5,385.73	$14,482.00
Aetna Facility/Professional Professional Modifier Low / Median / High Price $2,456.71 / $2,723.18 / $10,624.50	Professional		$2,456.71	$2,723.18	$10,624.50
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $8,139.00 / $13,906.00 / $22,165.00	Facility		$8,139.00	$13,906.00	$22,165.00
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $2,540.86 / $5,109.45 / $15,753.45	Professional		$2,540.86	$5,109.45	$15,753.45
Cigna Facility/Professional Facility Modifier Low / Median / High Price $6,783.63 / $7,927.21 / $12,160.54	Facility		$6,783.63	$7,927.21	$12,160.54
Cigna Facility/Professional Professional Modifier Low / Median / High Price $3,976.13 / $10,430.43 / $11,852.76	Professional		$3,976.13	$10,430.43	$11,852.76
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $2,554.73 / $3,576.62 / $5,984.15	Facility		$2,554.73	$3,576.62	$5,984.15
Medica Facility/Professional Facility Modifier Low / Median / High Price $2,554.73 / $4,635.00 / $13,120.00	Facility		$2,554.73	$4,635.00	$13,120.00
Medica Facility/Professional Professional Modifier Low / Median / High Price $2,758.04 / $5,126.14 / $19,546.00	Professional		$2,758.04	$5,126.14	$19,546.00
Molina Facility/Professional Professional Modifier Low / Median / High Price $262.55 / $1,589.06 / $5,043.63	Professional		$262.55	$1,589.06	$5,043.63
Prevea360 Facility/Professional Facility Modifier Low / Median / High Price $2,554.73 / $3,557.20 / $5,984.15	Facility		$2,554.73	$3,557.20	$5,984.15
Quartz Facility/Professional Professional Modifier Low / Median / High Price $5,252.65 / $6,400.15 / $9,554.17	Professional		$5,252.65	$6,400.15	$9,554.17
Quartz Facility/Professional Facility Modifier Low / Median / High Price $27,933.12 / $27,933.12 / $27,933.12	Facility		$27,933.12	$27,933.12	$27,933.12
Quartz Facility/Professional Professional Modifier Low / Median / High Price $4,879.93 / $12,648.25 / $19,546.00	Professional		$4,879.93	$12,648.25	$19,546.00
Security Health Facility/Professional Professional Modifier Low / Median / High Price $8,449.73 / $8,449.73 / $8,449.73	Professional		$8,449.73	$8,449.73	$8,449.73
Security Health Facility/Professional Professional Modifier Low / Median / High Price $6,402.75 / $13,004.67 / $16,599.37	Professional		$6,402.75	$13,004.67	$16,599.37
United Facility/Professional Facility Modifier Low / Median / High Price $5,266.00 / $11,608.00 / $13,980.00	Facility		$5,266.00	$11,608.00	$13,980.00
United Facility/Professional Professional Modifier Low / Median / High Price $2,646.61 / $4,758.53 / $11,509.91	Professional		$2,646.61	$4,758.53	$11,509.91