Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $1,329.61 / $2,534.40 / $14,482.00	Facility		$1,329.61	$2,534.40	$14,482.00
Aetna Facility/Professional Professional Modifier Low / Median / High Price $1,248.69 / $1,329.61 / $4,306.60	Professional		$1,248.69	$1,329.61	$4,306.60
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $5,169.00 / $8,593.00 / $12,444.00	Facility		$5,169.00	$8,593.00	$12,444.00
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $1,219.08 / $3,227.58 / $7,012.08	Professional		$1,219.08	$3,227.58	$7,012.08
Cigna Facility/Professional Facility Modifier Low / Median / High Price $3,178.25 / $3,714.04 / $5,990.61	Facility		$3,178.25	$3,714.04	$5,990.61
Cigna Facility/Professional Professional Modifier Low / Median / High Price $1,678.34 / $3,849.51 / $5,086.72	Professional		$1,678.34	$3,849.51	$5,086.72
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $1,239.04 / $1,555.64 / $2,421.76	Facility		$1,239.04	$1,555.64	$2,421.76
Medica Facility/Professional Facility Modifier Low / Median / High Price $1,329.61 / $5,031.39 / $14,978.00	Facility		$1,329.61	$5,031.39	$14,978.00
Medica Facility/Professional Professional Modifier Low / Median / High Price $1,445.90 / $2,975.63 / $6,548.45	Professional		$1,445.90	$2,975.63	$6,548.45
Molina Facility/Professional Professional Modifier Low / Median / High Price $85.00 / $997.88 / $2,564.11	Professional		$85.00	$997.88	$2,564.11
Prevea360 Facility/Professional Facility Modifier Low / Median / High Price $1,239.04 / $1,555.64 / $2,421.76	Facility		$1,239.04	$1,555.64	$2,421.76
Quartz Facility/Professional Professional Modifier Low / Median / High Price $2,416.05 / $3,730.75 / $4,394.60	Professional		$2,416.05	$3,730.75	$4,394.60
Quartz Facility/Professional Facility Modifier Low / Median / High Price $10,098.20 / $10,098.20 / $10,098.20	Facility		$10,098.20	$10,098.20	$10,098.20
Quartz Facility/Professional Professional Modifier Low / Median / High Price $1,715.46 / $6,056.25 / $12,343.06	Professional		$1,715.46	$6,056.25	$12,343.06
Security Health Facility/Professional Professional Modifier Low / Median / High Price $3,375.45 / $3,375.45 / $3,375.45	Professional		$3,375.45	$3,375.45	$3,375.45
Security Health Facility/Professional Professional Modifier Low / Median / High Price $3,545.91 / $5,959.83 / $5,959.83	Professional		$3,545.91	$5,959.83	$5,959.83
United Facility/Professional Facility Modifier Low / Median / High Price $7,301.00 / $11,608.00 / $13,980.00	Facility		$7,301.00	$11,608.00	$13,980.00
United Facility/Professional Professional Modifier Low / Median / High Price $1,357.58 / $3,399.70 / $5,743.61	Professional		$1,357.58	$3,399.70	$5,743.61