Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $1,006.22 / $2,208.73 / $14,482.00	Facility		$1,006.22	$2,208.73	$14,482.00
Aetna Facility/Professional Professional Modifier Low / Median / High Price $1,006.22 / $1,078.34 / $4,172.05	Professional		$1,006.22	$1,078.34	$4,172.05
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 $1,059.09 / $2,464.19 / $6,216.15	Professional		$1,059.09	$2,464.19	$6,216.15
Cigna Facility/Professional Facility Modifier Low / Median / High Price $2,820.51 / $3,295.98 / $5,056.12	Facility		$2,820.51	$3,295.98	$5,056.12
Cigna Facility/Professional Professional Modifier Low / Median / High Price $1,681.60 / $4,191.77 / $4,763.38	Professional		$1,681.60	$4,191.77	$4,763.38
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $1,006.22 / $1,348.94 / $2,182.42	Facility		$1,006.22	$1,348.94	$2,182.42
Medica Facility/Professional Facility Modifier Low / Median / High Price $1,006.22 / $1,556.56 / $13,250.00	Facility		$1,006.22	$1,556.56	$13,250.00
Medica Facility/Professional Professional Modifier Low / Median / High Price $1,215.26 / $2,170.34 / $8,063.68	Professional		$1,215.26	$2,170.34	$8,063.68
Molina Facility/Professional Professional Modifier Low / Median / High Price $122.95 / $845.73 / $2,228.43	Professional		$122.95	$845.73	$2,228.43
Prevea360 Facility/Professional Facility Modifier Low / Median / High Price $1,006.22 / $1,287.40 / $2,182.42	Facility		$1,006.22	$1,287.40	$2,182.42
Quartz Facility/Professional Professional Modifier Low / Median / High Price $2,112.50 / $2,574.00 / $3,842.48	Professional		$2,112.50	$2,574.00	$3,842.48
Quartz Facility/Professional Facility Modifier Low / Median / High Price $8,046.36 / $8,046.36 / $22,211.50	Facility		$8,046.36	$8,046.36	$22,211.50
Quartz Facility/Professional Professional Modifier Low / Median / High Price $2,105.92 / $5,257.40 / $8,063.68	Professional		$2,105.92	$5,257.40	$8,063.68
Security Health Facility/Professional Professional Modifier Low / Median / High Price $3,793.36 / $3,793.36 / $3,793.36	Professional		$3,793.36	$3,793.36	$3,793.36
Security Health Facility/Professional Professional Modifier Low / Median / High Price $3,587.69 / $6,163.63 / $6,276.81	Professional		$3,587.69	$6,163.63	$6,276.81
United Facility/Professional Facility Modifier Low / Median / High Price $5,266.00 / $11,608.00 / $13,980.00	Facility		$5,266.00	$11,608.00	$13,980.00
United Facility/Professional Professional Modifier Low / Median / High Price $1,162.86 / $2,102.61 / $4,731.66	Professional		$1,162.86	$2,102.61	$4,731.66