Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $1,182.75 / $2,645.89 / $4,715.56	Facility		$1,182.75	$2,645.89	$4,715.56
Aetna Facility/Professional Professional Modifier Low / Median / High Price $1,140.53 / $1,213.21 / $4,464.04	Professional		$1,140.53	$1,213.21	$4,464.04
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 $1,254.44 / $3,492.69 / $9,597.76	Professional		$1,254.44	$3,492.69	$9,597.76
Cigna Facility/Professional Facility Modifier Low / Median / High Price $3,317.02 / $3,876.20 / $6,252.18	Facility		$3,317.02	$3,876.20	$6,252.18
Cigna Facility/Professional Professional Modifier Low / Median / High Price $2,351.89 / $4,974.84 / $5,653.23	Professional		$2,351.89	$4,974.84	$5,653.23
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $1,182.75 / $1,516.11 / $2,528.29	Facility		$1,182.75	$1,516.11	$2,528.29
Medica Facility/Professional Facility Modifier Low / Median / High Price $1,293.55 / $8,627.00 / $16,779.00	Facility		$1,293.55	$8,627.00	$16,779.00
Medica Facility/Professional Professional Modifier Low / Median / High Price $1,315.97 / $3,077.84 / $8,437.87	Professional		$1,315.97	$3,077.84	$8,437.87
Molina Facility/Professional Professional Modifier Low / Median / High Price $132.78 / $881.44 / $2,828.98	Professional		$132.78	$881.44	$2,828.98
Prevea360 Facility/Professional Facility Modifier Low / Median / High Price $1,182.75 / $1,516.11 / $2,528.29	Facility		$1,182.75	$1,516.11	$2,528.29
Quartz Facility/Professional Professional Modifier Low / Median / High Price $2,748.85 / $4,229.00 / $5,605.68	Professional		$2,748.85	$4,229.00	$5,605.68
Quartz Facility/Professional Facility Modifier Low / Median / High Price $12,762.56 / $12,762.56 / $12,762.56	Facility		$12,762.56	$12,762.56	$12,762.56
Quartz Facility/Professional Facility Modifier AS Low / Median / High Price $640.19 / $640.19 / $640.19	Facility	AS	$640.19	$640.19	$640.19
Quartz Facility/Professional Professional Modifier Low / Median / High Price $2,499.33 / $6,193.80 / $9,811.12	Professional		$2,499.33	$6,193.80	$9,811.12
Security Health Facility/Professional Professional Modifier Low / Median / High Price $4,319.26 / $7,449.37 / $7,449.37	Professional		$4,319.26	$7,449.37	$7,449.37
United Facility/Professional Facility Modifier Low / Median / High Price $8,627.00 / $12,373.00 / $15,090.00	Facility		$8,627.00	$12,373.00	$15,090.00
United Facility/Professional Professional Modifier Low / Median / High Price $1,326.94 / $3,809.61 / $6,850.22	Professional		$1,326.94	$3,809.61	$6,850.22