Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $1,238.55 / $2,763.14 / $14,482.00	Facility		$1,238.55	$2,763.14	$14,482.00
Aetna Facility/Professional Professional Modifier Low / Median / High Price $1,238.55 / $1,339.42 / $5,219.26	Professional		$1,238.55	$1,339.42	$5,219.26
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $6,538.00 / $9,720.00 / $15,579.70	Facility		$6,538.00	$9,720.00	$15,579.70
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $1,305.80 / $2,939.06 / $7,279.80	Professional		$1,305.80	$2,939.06	$7,279.80
Cigna Facility/Professional Facility Modifier Low / Median / High Price $3,475.62 / $4,061.54 / $6,230.50	Facility		$3,475.62	$4,061.54	$6,230.50
Cigna Facility/Professional Professional Modifier Low / Median / High Price $2,089.23 / $5,186.18 / $5,893.40	Professional		$2,089.23	$5,186.18	$5,893.40
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $1,238.55 / $1,657.22 / $2,757.70	Facility		$1,238.55	$1,657.22	$2,757.70
Medica Facility/Professional Facility Modifier Low / Median / High Price $1,238.55 / $1,929.04 / $13,250.00	Facility		$1,238.55	$1,929.04	$13,250.00
Medica Facility/Professional Professional Modifier Low / Median / High Price $1,502.41 / $2,627.78 / $10,052.56	Professional		$1,502.41	$2,627.78	$10,052.56
Molina Facility/Professional Professional Modifier Low / Median / High Price $122.95 / $822.05 / $2,735.31	Professional		$122.95	$822.05	$2,735.31
Prevea360 Facility/Professional Facility Modifier Low / Median / High Price $1,238.55 / $1,608.22 / $2,757.70	Facility		$1,238.55	$1,608.22	$2,757.70
Quartz Facility/Professional Professional Modifier Low / Median / High Price $2,700.75 / $3,290.76 / $4,912.46	Professional		$2,700.75	$3,290.76	$4,912.46
Quartz Facility/Professional Facility Modifier Low / Median / High Price $6,348.38 / $6,348.38 / $17,524.30	Facility		$6,348.38	$6,348.38	$17,524.30
Quartz Facility/Professional Professional Modifier Low / Median / High Price $2,605.52 / $6,537.85 / $10,052.56	Professional		$2,605.52	$6,537.85	$10,052.56
Security Health Facility/Professional Professional Modifier Low / Median / High Price $4,664.59 / $4,664.59 / $4,664.59	Professional		$4,664.59	$4,664.59	$4,664.59
Security Health Facility/Professional Professional Modifier Low / Median / High Price $4,343.85 / $7,120.10 / $7,765.88	Professional		$4,343.85	$7,120.10	$7,765.88
United Facility/Professional Facility Modifier Low / Median / High Price $7,301.00 / $11,608.00 / $13,980.00	Facility		$7,301.00	$11,608.00	$13,980.00
United Facility/Professional Professional Modifier Low / Median / High Price $1,468.16 / $2,441.83 / $5,969.06	Professional		$1,468.16	$2,441.83	$5,969.06