Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $877.51 / $1,968.59 / $3,508.47	Facility		$877.51	$1,968.59	$3,508.47
Aetna Facility/Professional Professional Modifier Low / Median / High Price $877.51 / $1,030.38 / $4,389.00	Professional		$877.51	$1,030.38	$4,389.00
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $2,740.00 / $4,780.00 / $11,302.00	Facility		$2,740.00	$4,780.00	$11,302.00
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $922.43 / $2,567.84 / $7,130.00	Professional		$922.43	$2,567.84	$7,130.00
Cigna Facility/Professional Facility Modifier Low / Median / High Price $2,470.87 / $2,887.41 / $4,657.29	Facility		$2,470.87	$2,887.41	$4,657.29
Cigna Facility/Professional Professional Modifier Low / Median / High Price $1,749.85 / $3,695.74 / $4,199.70	Professional		$1,749.85	$3,695.74	$4,199.70
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $877.51 / $1,119.91 / $1,881.10	Facility		$877.51	$1,119.91	$1,881.10
Medica Facility/Professional Facility Modifier Low / Median / High Price $962.42 / $8,627.00 / $16,779.00	Facility		$962.42	$8,627.00	$16,779.00
Medica Facility/Professional Professional Modifier Low / Median / High Price $1,055.26 / $2,280.33 / $6,207.67	Professional		$1,055.26	$2,280.33	$6,207.67
Molina Facility/Professional Professional Modifier Low / Median / High Price $107.55 / $652.99 / $2,101.95	Professional		$107.55	$652.99	$2,101.95
Prevea360 Facility/Professional Facility Modifier Low / Median / High Price $877.51 / $1,119.91 / $1,881.10	Facility		$877.51	$1,119.91	$1,881.10
Quartz Facility/Professional Professional Modifier Low / Median / High Price $2,038.40 / $3,136.00 / $4,124.04	Professional		$2,038.40	$3,136.00	$4,124.04
Quartz Facility/Professional Facility Modifier Low / Median / High Price $9,455.12 / $9,455.12 / $9,455.12	Facility		$9,455.12	$9,455.12	$9,455.12
Quartz Facility/Professional Facility Modifier AS Low / Median / High Price $474.74 / $474.74 / $474.74	Facility	AS	$474.74	$474.74	$474.74
Quartz Facility/Professional Professional Modifier Low / Median / High Price $1,856.71 / $5,158.50 / $7,269.60	Professional		$1,856.71	$5,158.50	$7,269.60
Security Health Facility/Professional Professional Modifier Low / Median / High Price $3,213.62 / $5,534.01 / $5,534.01	Professional		$3,213.62	$5,534.01	$5,534.01
United Facility/Professional Facility Modifier Low / Median / High Price $7,984.00 / $12,373.00 / $15,090.00	Facility		$7,984.00	$12,373.00	$15,090.00
United Facility/Professional Professional Modifier Low / Median / High Price $1,094.56 / $2,801.33 / $5,043.99	Professional		$1,094.56	$2,801.33	$5,043.99