Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $1,194.59 / $2,663.78 / $14,482.00	Facility		$1,194.59	$2,663.78	$14,482.00
Aetna Facility/Professional Professional Modifier Low / Median / High Price $1,194.59 / $1,345.69 / $5,031.58	Professional		$1,194.59	$1,345.69	$5,031.58
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 $1,263.48 / $2,925.55 / $7,376.76	Professional		$1,263.48	$2,925.55	$7,376.76
Cigna Facility/Professional Facility Modifier Low / Median / High Price $3,350.36 / $3,915.17 / $6,005.96	Facility		$3,350.36	$3,915.17	$6,005.96
Cigna Facility/Professional Professional Modifier Low / Median / High Price $1,955.62 / $4,999.81 / $5,681.60	Professional		$1,955.62	$4,999.81	$5,681.60
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $1,194.59 / $1,695.60 / $2,691.93	Facility		$1,194.59	$1,695.60	$2,691.93
Medica Facility/Professional Facility Modifier Low / Median / High Price $1,194.59 / $1,900.80 / $13,250.00	Facility		$1,194.59	$1,900.80	$13,250.00
Medica Facility/Professional Professional Modifier Low / Median / High Price $1,399.42 / $2,582.23 / $9,692.08	Professional		$1,399.42	$2,582.23	$9,692.08
Molina Facility/Professional Professional Modifier Low / Median / High Price $123.62 / $801.24 / $2,639.39	Professional		$123.62	$801.24	$2,639.39
Prevea360 Facility/Professional Facility Modifier Low / Median / High Price $1,194.59 / $1,695.60 / $2,691.93	Facility		$1,194.59	$1,695.60	$2,691.93
Quartz Facility/Professional Professional Modifier Low / Median / High Price $2,603.25 / $3,171.96 / $4,735.10	Professional		$2,603.25	$3,171.96	$4,735.10
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 $2,511.87 / $6,306.35 / $9,692.08	Professional		$2,511.87	$6,306.35	$9,692.08
Security Health Facility/Professional Professional Modifier Low / Median / High Price $4,501.64 / $4,501.64 / $4,501.64	Professional		$4,501.64	$4,501.64	$4,501.64
Security Health Facility/Professional Professional Modifier Low / Median / High Price $4,268.58 / $7,278.44 / $7,486.75	Professional		$4,268.58	$7,278.44	$7,486.75
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 $1,399.42 / $2,582.23 / $5,713.55	Professional		$1,399.42	$2,582.23	$5,713.55