Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $2,227.48 / $3,605.76 / $14,482.00	Facility		$2,227.48	$3,605.76	$14,482.00
Aetna Facility/Professional Professional Modifier Low / Median / High Price $1,237.57 / $2,227.48 / $6,315.10	Professional		$1,237.57	$2,227.48	$6,315.10
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $12,080.00 / $17,505.00 / $23,937.00	Facility		$12,080.00	$17,505.00	$23,937.00
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $1,766.78 / $4,342.84 / $10,777.69	Professional		$1,766.78	$4,342.84	$10,777.69
Cigna Facility/Professional Facility Modifier Low / Median / High Price $4,500.18 / $5,258.83 / $8,482.31	Facility		$4,500.18	$5,258.83	$8,482.31
Cigna Facility/Professional Professional Modifier Low / Median / High Price $3,044.86 / $5,435.91 / $7,216.71	Professional		$3,044.86	$5,435.91	$7,216.71
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $1,762.82 / $2,789.95 / $3,938.73	Facility		$1,762.82	$2,789.95	$3,938.73
Medica Facility/Professional Facility Modifier Low / Median / High Price $2,032.56 / $3,445.50 / $7,700.00	Facility		$2,032.56	$3,445.50	$7,700.00
Medica Facility/Professional Professional Modifier Low / Median / High Price $2,139.83 / $5,424.22 / $10,371.70	Professional		$2,139.83	$5,424.22	$10,371.70
Molina Facility/Professional Professional Modifier Low / Median / High Price $112.28 / $1,262.90 / $3,934.80	Professional		$112.28	$1,262.90	$3,934.80
Prevea360 Facility/Professional Facility Modifier Low / Median / High Price $1,762.82 / $2,789.95 / $3,938.73	Facility		$1,762.82	$2,789.95	$3,938.73
Quartz Facility/Professional Professional Modifier Low / Median / High Price $3,621.80 / $5,592.62 / $7,308.32	Professional		$3,621.80	$5,592.62	$7,308.32
Quartz Facility/Professional Facility Modifier Low / Median / High Price $55,410.94 / $55,410.94 / $55,410.94	Facility		$55,410.94	$55,410.94	$55,410.94
Quartz Facility/Professional Professional Modifier Low / Median / High Price $3,120.41 / $8,795.25 / $19,602.00	Professional		$3,120.41	$8,795.25	$19,602.00
Security Health Facility/Professional Professional Modifier Low / Median / High Price $9,172.29 / $9,172.29 / $9,172.29	Professional		$9,172.29	$9,172.29	$9,172.29
Security Health Facility/Professional Professional Modifier Low / Median / High Price $8,187.48 / $12,180.95 / $12,180.95	Professional		$8,187.48	$12,180.95	$12,180.95
United Facility/Professional Facility Modifier Low / Median / High Price $2,203.00 / $4,316.80 / $19,003.00	Facility		$2,203.00	$4,316.80	$19,003.00
United Facility/Professional Professional Modifier Low / Median / High Price $2,110.86 / $5,374.15 / $8,639.11	Professional		$2,110.86	$5,374.15	$8,639.11