Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $1,370.25 / $2,846.25 / $14,482.00	Facility		$1,370.25	$2,846.25	$14,482.00
Aetna Facility/Professional Professional Modifier Low / Median / High Price $1,311.50 / $1,399.80 / $6,365.10	Professional		$1,311.50	$1,399.80	$6,365.10
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $6,538.00 / $10,800.00 / $18,360.00	Facility		$6,538.00	$10,800.00	$18,360.00
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $1,334.23 / $3,162.11 / $8,478.93	Professional		$1,334.23	$3,162.11	$8,478.93
Cigna Facility/Professional Facility Modifier Low / Median / High Price $3,610.79 / $4,219.49 / $6,472.81	Facility		$3,610.79	$4,219.49	$6,472.81
Cigna Facility/Professional Professional Modifier Low / Median / High Price $2,121.50 / $5,549.15 / $6,305.85	Professional		$2,121.50	$5,549.15	$6,305.85
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $1,370.25 / $1,897.50 / $3,028.25	Facility		$1,370.25	$1,897.50	$3,028.25
Medica Facility/Professional Facility Modifier Low / Median / High Price $1,370.25 / $2,768.48 / $13,120.00	Facility		$1,370.25	$2,768.48	$13,120.00
Medica Facility/Professional Professional Modifier Low / Median / High Price $1,583.40 / $2,730.49 / $11,584.70	Professional		$1,583.40	$2,730.49	$11,584.70
Molina Facility/Professional Professional Modifier Low / Median / High Price $126.60 / $829.00 / $2,632.81	Professional		$126.60	$829.00	$2,632.81
Prevea360 Facility/Professional Facility Modifier Low / Median / High Price $1,370.25 / $1,894.22 / $3,028.25	Facility		$1,370.25	$1,894.22	$3,028.25
Quartz Facility/Professional Professional Modifier Low / Median / High Price $2,725.45 / $3,320.86 / $4,957.38	Professional		$2,725.45	$3,320.86	$4,957.38
Quartz Facility/Professional Facility Modifier Low / Median / High Price $13,050.08 / $13,050.08 / $13,050.08	Facility		$13,050.08	$13,050.08	$13,050.08
Quartz Facility/Professional Professional Modifier Low / Median / High Price $2,596.19 / $6,658.05 / $11,584.70	Professional		$2,596.19	$6,658.05	$11,584.70
Security Health Facility/Professional Professional Modifier Low / Median / High Price $4,547.89 / $4,547.89 / $4,547.89	Professional		$4,547.89	$4,547.89	$4,547.89
Security Health Facility/Professional Professional Modifier Low / Median / High Price $3,794.34 / $7,336.88 / $8,831.11	Professional		$3,794.34	$7,336.88	$8,831.11
United Facility/Professional Facility Modifier Low / Median / High Price $7,301.00 / $11,608.00 / $13,980.00	Facility		$7,301.00	$11,608.00	$13,980.00
United Facility/Professional Professional Modifier Low / Median / High Price $1,507.45 / $2,703.27 / $6,389.46	Professional		$1,507.45	$2,703.27	$6,389.46