Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $707.45 / $1,582.33 / $14,482.00	Facility		$707.45	$1,582.33	$14,482.00
Aetna Facility/Professional Professional Modifier Low / Median / High Price $707.45 / $766.79 / $2,988.85	Professional		$707.45	$766.79	$2,988.85
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $6,538.00 / $10,800.00 / $19,822.18	Facility		$6,538.00	$10,800.00	$19,822.18
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $744.53 / $1,501.52 / $4,089.07	Professional		$744.53	$1,501.52	$4,089.07
Cigna Facility/Professional Facility Modifier Low / Median / High Price $1,995.08 / $2,331.41 / $3,576.44	Facility		$1,995.08	$2,331.41	$3,576.44
Cigna Facility/Professional Professional Modifier Low / Median / High Price $1,152.07 / $2,968.26 / $3,373.03	Professional		$1,152.07	$2,968.26	$3,373.03
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $707.45 / $1,042.33 / $1,582.34	Facility		$707.45	$1,042.33	$1,582.34
Medica Facility/Professional Facility Modifier Low / Median / High Price $707.45 / $1,273.41 / $5,887.00	Facility		$707.45	$1,273.41	$5,887.00
Medica Facility/Professional Professional Modifier Low / Median / High Price $733.27 / $1,362.33 / $6,736.51	Professional		$733.27	$1,362.33	$6,736.51
Molina Facility/Professional Professional Modifier Low / Median / High Price $62.75 / $617.47 / $1,613.93	Professional		$62.75	$617.47	$1,613.93
Prevea360 Facility/Professional Facility Modifier Low / Median / High Price $707.45 / $1,042.33 / $1,582.34	Facility		$707.45	$1,042.33	$1,582.34
Quartz Facility/Professional Professional Modifier Low / Median / High Price $1,541.80 / $1,878.62 / $2,693.64	Professional		$1,541.80	$1,878.62	$2,693.64
Quartz Facility/Professional Facility Modifier Low / Median / High Price $7,290.56 / $7,290.56 / $7,290.56	Facility		$7,290.56	$7,290.56	$7,290.56
Quartz Facility/Professional Professional Modifier Low / Median / High Price $1,491.23 / $3,709.65 / $6,736.51	Professional		$1,491.23	$3,709.65	$6,736.51
Security Health Facility/Professional Professional Modifier Low / Median / High Price $2,658.52 / $2,658.52 / $2,658.52	Professional		$2,658.52	$2,658.52	$2,658.52
Security Health Facility/Professional Professional Modifier Low / Median / High Price $1,864.81 / $3,636.70 / $4,444.64	Professional		$1,864.81	$3,636.70	$4,444.64
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 $733.27 / $1,382.88 / $3,251.51	Professional		$733.27	$1,382.88	$3,251.51