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 / $5,548.78	Professional		$1,875.00	$1,875.00	$5,548.78
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $5,169.00 / $7,344.00 / $10,382.04	Facility		$5,169.00	$7,344.00	$10,382.04
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $1,339.69 / $1,862.40 / $3,708.48	Professional		$1,339.69	$1,862.40	$3,708.48
Cigna Facility/Professional Professional Modifier Low / Median / High Price $364.00 / $599.76 / $6,588.36	Professional		$364.00	$599.76	$6,588.36
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $1,875.00 / $1,875.00 / $3,150.00	Facility		$1,875.00	$1,875.00	$3,150.00
Medica Facility/Professional Facility Modifier Low / Median / High Price $1,875.00 / $2,203.00 / $7,700.00	Facility		$1,875.00	$2,203.00	$7,700.00
Medica Facility/Professional Professional Modifier Low / Median / High Price $6,588.36 / $6,588.36 / $6,588.36	Professional		$6,588.36	$6,588.36	$6,588.36
Molina Facility/Professional Professional Modifier Low / Median / High Price $50.00 / $70.00 / $1,476.70	Professional		$50.00	$70.00	$1,476.70
Prevea360 Facility/Professional Facility Modifier Low / Median / High Price $1,875.00 / $1,875.00 / $3,150.00	Facility		$1,875.00	$1,875.00	$3,150.00
Quartz Facility/Professional Facility Modifier Low / Median / High Price $4,714.20 / $4,714.20 / $4,714.20	Facility		$4,714.20	$4,714.20	$4,714.20
Quartz Facility/Professional Professional Modifier Low / Median / High Price $805.00 / $6,588.36 / $6,588.36	Professional		$805.00	$6,588.36	$6,588.36
United Facility/Professional Facility Modifier Low / Median / High Price $2,203.00 / $6,032.00 / $19,003.00	Facility		$2,203.00	$6,032.00	$19,003.00