Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $1,692.54 / $3,779.30 / $14,482.00	Facility		$1,692.54	$3,779.30	$14,482.00
Aetna Facility/Professional Professional Modifier Low / Median / High Price $1,692.54 / $1,759.31 / $6,400.46	Professional		$1,692.54	$1,759.31	$6,400.46
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $11,499.00 / $16,401.00 / $25,162.36	Facility		$11,499.00	$16,401.00	$25,162.36
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $1,785.55 / $4,779.21 / $13,719.04	Professional		$1,785.55	$4,779.21	$13,719.04
Cigna Facility/Professional Facility Modifier Low / Median / High Price $4,739.89 / $5,538.94 / $8,934.11	Facility		$4,739.89	$5,538.94	$8,934.11
Cigna Facility/Professional Professional Modifier Low / Median / High Price $3,359.37 / $7,111.05 / $8,080.74	Professional		$3,359.37	$7,111.05	$8,080.74
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $1,692.54 / $2,499.77 / $3,866.91	Facility		$1,692.54	$2,499.77	$3,866.91
Medica Facility/Professional Facility Modifier Low / Median / High Price $1,738.23 / $3,364.00 / $7,700.00	Facility		$1,738.23	$3,364.00	$7,700.00
Medica Facility/Professional Professional Modifier Low / Median / High Price $2,143.06 / $4,965.03 / $13,693.52	Professional		$2,143.06	$4,965.03	$13,693.52
Molina Facility/Professional Professional Modifier Low / Median / High Price $174.52 / $1,277.12 / $4,040.08	Professional		$174.52	$1,277.12	$4,040.08
Prevea360 Facility/Professional Facility Modifier Low / Median / High Price $1,692.54 / $2,499.77 / $3,866.91	Facility		$1,692.54	$2,499.77	$3,866.91
Quartz Facility/Professional Professional Modifier Low / Median / High Price $3,940.95 / $6,063.00 / $8,017.27	Professional		$3,940.95	$6,063.00	$8,017.27
Quartz Facility/Professional Facility Modifier Low / Median / High Price $27,428.88 / $27,428.88 / $27,428.88	Facility		$27,428.88	$27,428.88	$27,428.88
Quartz Facility/Professional Professional Modifier Low / Median / High Price $3,572.55 / $8,874.15 / $14,039.20	Professional		$3,572.55	$8,874.15	$14,039.20
Security Health Facility/Professional Professional Modifier Low / Median / High Price $6,373.89 / $6,373.89 / $6,373.89	Professional		$6,373.89	$6,373.89	$6,373.89
Security Health Facility/Professional Professional Modifier Low / Median / High Price $6,169.50 / $10,648.16 / $10,648.16	Professional		$6,169.50	$10,648.16	$10,648.16
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 $2,129.80 / $5,453.30 / $8,969.28	Professional		$2,129.80	$5,453.30	$8,969.28