Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $1,862.15 / $4,160.22 / $14,482.00	Facility		$1,862.15	$4,160.22	$14,482.00
Aetna Facility/Professional Professional Modifier Low / Median / High Price $1,862.15 / $2,203.19 / $7,046.09	Professional		$1,862.15	$2,203.19	$7,046.09
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 $1,965.13 / $4,560.37 / $11,484.24	Professional		$1,965.13	$4,560.37	$11,484.24
Cigna Facility/Professional Facility Modifier Low / Median / High Price $5,216.58 / $6,095.99 / $9,351.41	Facility		$5,216.58	$6,095.99	$9,351.41
Cigna Facility/Professional Professional Modifier Low / Median / High Price $3,078.77 / $7,824.89 / $8,891.93	Professional		$3,078.77	$7,824.89	$8,891.93
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $1,862.15 / $2,556.03 / $4,549.60	Facility		$1,862.15	$2,556.03	$4,549.60
Medica Facility/Professional Facility Modifier Low / Median / High Price $1,873.74 / $2,803.00 / $6,235.00	Facility		$1,873.74	$2,803.00	$6,235.00
Medica Facility/Professional Professional Modifier Low / Median / High Price $2,271.48 / $3,988.32 / $15,444.48	Professional		$2,271.48	$3,988.32	$15,444.48
Molina Facility/Professional Professional Modifier Low / Median / High Price $200.61 / $1,358.59 / $4,374.16	Professional		$200.61	$1,358.59	$4,374.16
Prevea360 Facility/Professional Facility Modifier Low / Median / High Price $1,862.15 / $2,534.40 / $4,549.60	Facility		$1,862.15	$2,534.40	$4,549.60
Quartz Facility/Professional Professional Modifier Low / Median / High Price $4,336.14 / $5,283.43 / $7,887.12	Professional		$4,336.14	$5,283.43	$7,887.12
Quartz Facility/Professional Facility Modifier Low / Median / High Price $40,229.76 / $40,229.76 / $40,229.76	Facility		$40,229.76	$40,229.76	$40,229.76
Quartz Facility/Professional Professional Modifier Low / Median / High Price $3,931.19 / $9,759.20 / $15,444.48	Professional		$3,931.19	$9,759.20	$15,444.48
Security Health Facility/Professional Professional Modifier Low / Median / High Price $7,008.18 / $7,008.18 / $7,008.18	Professional		$7,008.18	$7,008.18	$7,008.18
Security Health Facility/Professional Professional Modifier Low / Median / High Price $6,592.92 / $11,351.54 / $11,717.11	Professional		$6,592.92	$11,351.54	$11,717.11
United Facility/Professional Facility Modifier Low / Median / High Price $2,203.00 / $4,810.00 / $19,003.00	Facility		$2,203.00	$4,810.00	$19,003.00
United Facility/Professional Professional Modifier Low / Median / High Price $2,061.80 / $3,584.24 / $8,553.94	Professional		$2,061.80	$3,584.24	$8,553.94