Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $2,841.99 / $4,595.56 / $14,482.00	Facility		$2,841.99	$4,595.56	$14,482.00
Aetna Facility/Professional Professional Modifier Low / Median / High Price $1,662.32 / $2,841.99 / $8,055.60	Professional		$1,662.32	$2,841.99	$8,055.60
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $8,712.00 / $12,656.00 / $19,835.00	Facility		$8,712.00	$12,656.00	$19,835.00
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $2,259.58 / $5,548.81 / $13,763.61	Professional		$2,259.58	$5,548.81	$13,763.61
Cigna Facility/Professional Facility Modifier Low / Median / High Price $5,730.22 / $6,696.22 / $10,800.76	Facility		$5,730.22	$6,696.22	$10,800.76
Cigna Facility/Professional Professional Modifier Low / Median / High Price $3,880.69 / $6,930.50 / $9,187.78	Professional		$3,880.69	$6,930.50	$9,187.78
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $2,246.71 / $3,163.41 / $4,440.74	Facility		$2,246.71	$3,163.41	$4,440.74
Medica Facility/Professional Facility Modifier Low / Median / High Price $2,246.71 / $3,563.25 / $7,868.00	Facility		$2,246.71	$3,563.25	$7,868.00
Medica Facility/Professional Professional Modifier Low / Median / High Price $2,717.33 / $6,926.07 / $12,644.52	Professional		$2,717.33	$6,926.07	$12,644.52
Molina Facility/Professional Professional Modifier Low / Median / High Price $138.70 / $1,613.68 / $5,008.88	Professional		$138.70	$1,613.68	$5,008.88
Prevea360 Facility/Professional Facility Modifier Low / Median / High Price $2,246.71 / $3,163.41 / $4,440.74	Facility		$2,246.71	$3,163.41	$4,440.74
Quartz Facility/Professional Professional Modifier Low / Median / High Price $4,624.10 / $7,140.32 / $9,317.71	Professional		$4,624.10	$7,140.32	$9,317.71
Quartz Facility/Professional Facility Modifier Low / Median / High Price $57,131.76 / $57,131.76 / $57,131.76	Facility		$57,131.76	$57,131.76	$57,131.76
Quartz Facility/Professional Professional Modifier Low / Median / High Price $3,978.36 / $11,248.20 / $22,841.74	Professional		$3,978.36	$11,248.20	$22,841.74
Security Health Facility/Professional Professional Modifier Low / Median / High Price $11,713.41 / $11,713.41 / $11,713.41	Professional		$11,713.41	$11,713.41	$11,713.41
Security Health Facility/Professional Professional Modifier Low / Median / High Price $10,601.40 / $15,530.14 / $15,530.14	Professional		$10,601.40	$15,530.14	$15,530.14
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 $2,717.33 / $6,926.07 / $11,041.38	Professional		$2,717.33	$6,926.07	$11,041.38