Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $2,648.26 / $4,298.93 / $14,482.00	Facility		$2,648.26	$4,298.93	$14,482.00
Aetna Facility/Professional Professional Modifier Low / Median / High Price $1,439.60 / $2,648.26 / $7,272.44	Professional		$1,439.60	$2,648.26	$7,272.44
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $6,538.00 / $10,196.00 / $17,436.00	Facility		$6,538.00	$10,196.00	$17,436.00
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $2,070.44 / $5,121.82 / $12,801.04	Professional		$2,070.44	$5,121.82	$12,801.04
Cigna Facility/Professional Facility Modifier Low / Median / High Price $5,374.28 / $6,280.27 / $10,129.85	Facility		$5,374.28	$6,280.27	$10,129.85
Cigna Facility/Professional Professional Modifier Low / Median / High Price $3,923.61 / $6,467.78 / $8,638.18	Professional		$3,923.61	$6,467.78	$8,638.18
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $2,101.69 / $2,898.63 / $4,107.88	Facility		$2,101.69	$2,898.63	$4,107.88
Medica Facility/Professional Facility Modifier Low / Median / High Price $2,101.69 / $3,307.73 / $7,700.00	Facility		$2,101.69	$3,307.73	$7,700.00
Medica Facility/Professional Professional Modifier Low / Median / High Price $2,165.77 / $6,216.52 / $12,200.59	Professional		$2,165.77	$6,216.52	$12,200.59
Molina Facility/Professional Professional Modifier Low / Median / High Price $138.70 / $1,496.58 / $4,665.37	Professional		$138.70	$1,496.58	$4,665.37
Prevea360 Facility/Professional Facility Modifier Low / Median / High Price $2,101.69 / $2,898.63 / $4,107.88	Facility		$2,101.69	$2,898.63	$4,107.88
Quartz Facility/Professional Professional Modifier Low / Median / High Price $4,312.10 / $6,658.55 / $8,695.61	Professional		$4,312.10	$6,658.55	$8,695.61
Quartz Facility/Professional Facility Modifier Low / Median / High Price $40,539.83 / $40,539.83 / $40,539.83	Facility		$40,539.83	$40,539.83	$40,539.83
Quartz Facility/Professional Professional Modifier Low / Median / High Price $4,025.38 / $10,346.15 / $15,864.88	Professional		$4,025.38	$10,346.15	$15,864.88
Security Health Facility/Professional Professional Modifier Low / Median / High Price $10,894.22 / $10,894.22 / $10,894.22	Professional		$10,894.22	$10,894.22	$10,894.22
Security Health Facility/Professional Professional Modifier Low / Median / High Price $9,633.23 / $14,493.24 / $14,493.24	Professional		$9,633.23	$14,493.24	$14,493.24
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 $2,165.77 / $6,287.75 / $11,559.74	Professional		$2,165.77	$6,287.75	$11,559.74