Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $930.69 / $1,658.70 / $10,623.50	Facility		$930.69	$1,658.70	$10,623.50
Aetna Facility/Professional Professional Modifier Low / Median / High Price $1,658.70 / $2,522.96 / $21,273.60	Professional		$1,658.70	$2,522.96	$21,273.60
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $10,878.00 / $15,141.00 / $22,609.00	Facility		$10,878.00	$15,141.00	$22,609.00
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $733.55 / $4,068.92 / $17,536.31	Professional		$733.55	$4,068.92	$17,536.31
Anthem BCBS Facility/Professional Professional Modifier 50 Low / Median / High Price $1,294.51 / $6,103.38 / $26,432.52	Professional	50	$1,294.51	$6,103.38	$26,432.52
Cigna Facility/Professional Facility Modifier Low / Median / High Price $8,183.97 / $9,563.62 / $15,425.78	Facility		$8,183.97	$9,563.62	$15,425.78
Cigna Facility/Professional Professional Modifier Low / Median / High Price $1,125.23 / $1,853.09 / $11,830.64	Professional		$1,125.23	$1,853.09	$11,830.64
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $496.37 / $1,038.35 / $5,696.49	Facility		$496.37	$1,038.35	$5,696.49
Medica Facility/Professional Facility Modifier Low / Median / High Price $524.82 / $6,180.00 / $19,754.00	Facility		$524.82	$6,180.00	$19,754.00
Medica Facility/Professional Professional Modifier Low / Median / High Price $4,691.18 / $13,456.18 / $22,277.85	Professional		$4,691.18	$13,456.18	$22,277.85
Molina Facility/Professional Professional Modifier Low / Median / High Price $85.00 / $2,744.05 / $7,395.96	Professional		$85.00	$2,744.05	$7,395.96
Prevea360 Facility/Professional Facility Modifier Low / Median / High Price $496.37 / $1,038.35 / $5,696.49	Facility		$496.37	$1,038.35	$5,696.49
Quartz Facility/Professional Professional Modifier Low / Median / High Price $1,106.49 / $3,114.64 / $9,833.16	Professional		$1,106.49	$3,114.64	$9,833.16
Quartz Facility/Professional Facility Modifier Low / Median / High Price $4,897.51 / $4,897.51 / $4,897.51	Facility		$4,897.51	$4,897.51	$4,897.51
Quartz Facility/Professional Facility Modifier AS Low / Median / High Price $217.54 / $217.54 / $217.54	Facility	AS	$217.54	$217.54	$217.54
Quartz Facility/Professional Professional Modifier Low / Median / High Price $2,318.60 / $13,544.27 / $23,107.71	Professional		$2,318.60	$13,544.27	$23,107.71
United Facility/Professional Professional Modifier Low / Median / High Price $4,362.50 / $11,448.37 / $19,337.24	Professional		$4,362.50	$11,448.37	$19,337.24