Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $1,875.00 / $1,875.00 / $17,823.00	Facility		$1,875.00	$1,875.00	$17,823.00
Aetna Facility/Professional Professional Modifier Low / Median / High Price $1,875.00 / $1,875.00 / $1,915.28	Professional		$1,875.00	$1,875.00	$1,915.28
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $7,084.00 / $11,783.00 / $18,458.00	Facility		$7,084.00	$11,783.00	$18,458.00
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $676.59 / $676.59 / $3,276.59	Professional		$676.59	$676.59	$3,276.59
Cigna Facility/Professional Facility Modifier Low / Median / High Price $2,843.03 / $3,322.31 / $5,358.77	Facility		$2,843.03	$3,322.31	$5,358.77
Cigna Facility/Professional Professional Modifier Low / Median / High Price $1,733.04 / $2,602.88 / $5,438.50	Professional		$1,733.04	$2,602.88	$5,438.50
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $1,875.00 / $1,875.00 / $2,520.00	Facility		$1,875.00	$1,875.00	$2,520.00
Medica Facility/Professional Facility Modifier Low / Median / High Price $1,875.00 / $3,583.00 / $9,547.50	Facility		$1,875.00	$3,583.00	$9,547.50
Medica Facility/Professional Professional Modifier Low / Median / High Price $11,402.93 / $11,402.93 / $11,402.93	Professional		$11,402.93	$11,402.93	$11,402.93
Molina Facility/Professional Professional Modifier Low / Median / High Price $50.00 / $65.00 / $85.00	Professional		$50.00	$65.00	$85.00
Prevea360 Facility/Professional Facility Modifier Low / Median / High Price $1,875.00 / $1,875.00 / $2,520.00	Facility		$1,875.00	$1,875.00	$2,520.00
Quartz Facility/Professional Professional Modifier Low / Median / High Price $11,402.93 / $11,402.93 / $11,402.93	Professional		$11,402.93	$11,402.93	$11,402.93
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