Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $971.85 / $1,565.82 / $14,482.00	Facility		$971.85	$1,565.82	$14,482.00
Aetna Facility/Professional Professional Modifier Low / Median / High Price $581.25 / $971.85 / $1,565.82	Professional		$581.25	$971.85	$1,565.82
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $1,905.00 / $3,496.00 / $5,962.00	Facility		$1,905.00	$3,496.00	$5,962.00
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $778.41 / $1,898.44 / $4,709.96	Professional		$778.41	$1,898.44	$4,709.96
Cigna Facility/Professional Facility Modifier Low / Median / High Price $1,946.42 / $2,274.54 / $3,668.76	Facility		$1,946.42	$2,274.54	$3,668.76
Cigna Facility/Professional Professional Modifier Low / Median / High Price $1,322.25 / $2,359.63 / $3,123.50	Professional		$1,322.25	$2,359.63	$3,123.50
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $765.51 / $1,089.77 / $1,509.64	Facility		$765.51	$1,089.77	$1,509.64
Medica Facility/Professional Facility Modifier Low / Median / High Price $881.94 / $2,803.00 / $7,868.00	Facility		$881.94	$2,803.00	$7,868.00
Medica Facility/Professional Professional Modifier Low / Median / High Price $934.39 / $2,694.77 / $4,356.07	Professional		$934.39	$2,694.77	$4,356.07
Molina Facility/Professional Professional Modifier Low / Median / High Price $85.00 / $1,072.72 / $2,096.16	Professional		$85.00	$1,072.72	$2,096.16
Prevea360 Facility/Professional Facility Modifier Low / Median / High Price $765.51 / $1,089.77 / $1,509.64	Facility		$765.51	$1,089.77	$1,509.64
Quartz Facility/Professional Professional Modifier Low / Median / High Price $1,569.75 / $2,423.94 / $3,172.41	Professional		$1,569.75	$2,423.94	$3,172.41
Quartz Facility/Professional Facility Modifier Low / Median / High Price $14,786.24 / $14,786.24 / $14,786.24	Facility		$14,786.24	$14,786.24	$14,786.24
Quartz Facility/Professional Professional Modifier Low / Median / High Price $1,354.50 / $3,860.70 / $5,814.08	Professional		$1,354.50	$3,860.70	$5,814.08
Security Health Facility/Professional Professional Modifier Low / Median / High Price $4,008.39 / $4,008.39 / $4,008.39	Professional		$4,008.39	$4,008.39	$4,008.39
Security Health Facility/Professional Professional Modifier Low / Median / High Price $5,287.50 / $5,287.50 / $5,287.50	Professional		$5,287.50	$5,287.50	$5,287.50
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 $934.39 / $2,348.28 / $3,803.78	Professional		$934.39	$2,348.28	$3,803.78