Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $1,156.24 / $1,874.36 / $14,482.00	Facility		$1,156.24	$1,874.36	$14,482.00
Aetna Facility/Professional Professional Modifier Low / Median / High Price $648.91 / $1,156.24 / $3,378.42	Professional		$648.91	$1,156.24	$3,378.42
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $6,538.00 / $9,948.00 / $15,579.70	Facility		$6,538.00	$9,948.00	$15,579.70
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $913.22 / $2,186.13 / $5,428.69	Professional		$913.22	$2,186.13	$5,428.69
Cigna Facility/Professional Facility Modifier Low / Median / High Price $2,328.48 / $2,721.03 / $4,388.92	Facility		$2,328.48	$2,721.03	$4,388.92
Cigna Facility/Professional Professional Modifier Low / Median / High Price $1,582.80 / $2,824.21 / $4,050.48	Professional		$1,582.80	$2,824.21	$4,050.48
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $916.36 / $1,394.32 / $2,039.04	Facility		$916.36	$1,394.32	$2,039.04
Medica Facility/Professional Facility Modifier Low / Median / High Price $1,062.89 / $8,791.00 / $16,779.00	Facility		$1,062.89	$8,791.00	$16,779.00
Medica Facility/Professional Professional Modifier Low / Median / High Price $1,135.17 / $3,074.96 / $5,390.78	Professional		$1,135.17	$3,074.96	$5,390.78
Molina Facility/Professional Professional Modifier Low / Median / High Price $70.00 / $918.47 / $2,139.42	Professional		$70.00	$918.47	$2,139.42
Prevea360 Facility/Professional Facility Modifier Low / Median / High Price $916.36 / $1,394.32 / $2,039.04	Facility		$916.36	$1,394.32	$2,039.04
Quartz Facility/Professional Professional Modifier Low / Median / High Price $1,894.75 / $2,925.79 / $3,797.01	Professional		$1,894.75	$2,925.79	$3,797.01
Quartz Facility/Professional Facility Modifier Low / Median / High Price $13,856.55 / $13,856.55 / $13,856.55	Facility		$13,856.55	$13,856.55	$13,856.55
Quartz Facility/Professional Professional Modifier Low / Median / High Price $1,621.19 / $4,571.39 / $6,973.28	Professional		$1,621.19	$4,571.39	$6,973.28
Security Health Facility/Professional Professional Modifier Low / Median / High Price $4,758.18 / $4,758.18 / $4,758.18	Professional		$4,758.18	$4,758.18	$4,758.18
Security Health Facility/Professional Professional Modifier Low / Median / High Price $4,395.89 / $6,328.55 / $6,328.55	Professional		$4,395.89	$6,328.55	$6,328.55
United Facility/Professional Facility Modifier Low / Median / High Price $7,984.00 / $12,373.00 / $15,903.00	Facility		$7,984.00	$12,373.00	$15,903.00
United Facility/Professional Professional Modifier Low / Median / High Price $1,108.55 / $3,074.96 / $4,506.04	Professional		$1,108.55	$3,074.96	$4,506.04