Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $1,405.28 / $2,635.18 / $14,482.00	Facility		$1,405.28	$2,635.18	$14,482.00
Aetna Facility/Professional Professional Modifier Low / Median / High Price $1,144.52 / $1,405.28 / $4,449.56	Professional		$1,144.52	$1,405.28	$4,449.56
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $9,287.00 / $15,141.00 / $22,609.00	Facility		$9,287.00	$15,141.00	$22,609.00
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $1,253.72 / $3,481.20 / $7,141.44	Professional		$1,253.72	$3,481.20	$7,141.44
Cigna Facility/Professional Facility Modifier Low / Median / High Price $3,330.54 / $3,892.00 / $6,277.66	Facility		$3,330.54	$3,892.00	$6,277.66
Cigna Facility/Professional Professional Modifier Low / Median / High Price $1,932.47 / $3,818.62 / $5,284.30	Professional		$1,932.47	$3,818.62	$5,284.30
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $1,288.31 / $1,588.90 / $2,518.06	Facility		$1,288.31	$1,588.90	$2,518.06
Medica Facility/Professional Facility Modifier Low / Median / High Price $1,405.28 / $5,266.00 / $15,743.00	Facility		$1,405.28	$5,266.00	$15,743.00
Medica Facility/Professional Professional Modifier Low / Median / High Price $1,475.37 / $3,170.90 / $6,159.76	Professional		$1,475.37	$3,170.90	$6,159.76
Molina Facility/Professional Professional Modifier Low / Median / High Price $117.74 / $806.99 / $2,569.35	Professional		$117.74	$806.99	$2,569.35
Prevea360 Facility/Professional Facility Modifier Low / Median / High Price $1,288.31 / $1,588.90 / $2,518.06	Facility		$1,288.31	$1,588.90	$2,518.06
Quartz Facility/Professional Professional Modifier Low / Median / High Price $2,556.44 / $3,947.55 / $4,649.99	Professional		$2,556.44	$3,947.55	$4,649.99
Quartz Facility/Professional Facility Modifier Low / Median / High Price $16,298.90 / $16,298.90 / $16,298.90	Facility		$16,298.90	$16,298.90	$16,298.90
Quartz Facility/Professional Professional Modifier Low / Median / High Price $1,991.35 / $6,341.80 / $9,704.08	Professional		$1,991.35	$6,341.80	$9,704.08
Security Health Facility/Professional Professional Modifier Low / Median / High Price $3,210.60 / $3,210.60 / $3,210.60	Professional		$3,210.60	$3,210.60	$3,210.60
Security Health Facility/Professional Professional Modifier Low / Median / High Price $3,414.26 / $6,975.87 / $6,975.87	Professional		$3,414.26	$6,975.87	$6,975.87
United Facility/Professional Facility Modifier Low / Median / High Price $7,217.00 / $11,608.00 / $13,980.00	Facility		$7,217.00	$11,608.00	$13,980.00
United Facility/Professional Professional Modifier Low / Median / High Price $1,512.60 / $3,667.58 / $5,558.59	Professional		$1,512.60	$3,667.58	$5,558.59