Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $1,798.38 / $1,798.38 / $3,205.11	Facility		$1,798.38	$1,798.38	$3,205.11
Aetna Facility/Professional Professional Modifier Low / Median / High Price $1,798.38 / $3,269.80 / $4,846.14	Professional		$1,798.38	$3,269.80	$4,846.14
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 $889.31 / $2,168.60 / $5,399.73	Professional		$889.31	$2,168.60	$5,399.73
Cigna Facility/Professional Facility Modifier Low / Median / High Price $2,223.96 / $2,598.88 / $4,191.89	Facility		$2,223.96	$2,598.88	$4,191.89
Cigna Facility/Professional Professional Modifier Low / Median / High Price $1,684.54 / $2,712.73 / $3,565.19	Professional		$1,684.54	$2,712.73	$3,565.19
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $879.21 / $1,245.03 / $1,723.07	Facility		$879.21	$1,245.03	$1,723.07
Medica Facility/Professional Facility Modifier Low / Median / High Price $1,023.08 / $2,803.00 / $7,868.00	Facility		$1,023.08	$2,803.00	$7,868.00
Medica Facility/Professional Professional Modifier Low / Median / High Price $1,082.53 / $2,958.15 / $5,019.89	Professional		$1,082.53	$2,958.15	$5,019.89
Molina Facility/Professional Professional Modifier Low / Median / High Price $85.00 / $1,315.29 / $2,292.21	Professional		$85.00	$1,315.29	$2,292.21
Prevea360 Facility/Professional Facility Modifier Low / Median / High Price $879.21 / $1,245.03 / $1,723.07	Facility		$879.21	$1,245.03	$1,723.07
Quartz Facility/Professional Professional Modifier Low / Median / High Price $1,829.10 / $2,824.41 / $3,647.13	Professional		$1,829.10	$2,824.41	$3,647.13
Quartz Facility/Professional Facility Modifier Low / Median / High Price $11,798.93 / $11,798.93 / $11,798.93	Facility		$11,798.93	$11,798.93	$11,798.93
Quartz Facility/Professional Professional Modifier Low / Median / High Price $3,688.11 / $4,446.70 / $10,107.12	Professional		$3,688.11	$4,446.70	$10,107.12
United Facility/Professional Facility Modifier Low / Median / High Price $2,534.00 / $2,534.00 / $2,534.00	Facility		$2,534.00	$2,534.00	$2,534.00
United Facility/Professional Professional Modifier Low / Median / High Price $1,082.53 / $3,017.74 / $5,019.89	Professional		$1,082.53	$3,017.74	$5,019.89