Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $1,236.35 / $2,759.49 / $14,482.00	Facility		$1,236.35	$2,759.49	$14,482.00
Aetna Facility/Professional Professional Modifier Low / Median / High Price $1,236.35 / $1,390.90 / $5,212.37	Professional		$1,236.35	$1,390.90	$5,212.37
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 $1,308.20 / $3,027.81 / $7,628.71	Professional		$1,308.20	$3,027.81	$7,628.71
Cigna Facility/Professional Facility Modifier Low / Median / High Price $3,472.02 / $4,057.32 / $6,224.04	Facility		$3,472.02	$4,057.32	$6,224.04
Cigna Facility/Professional Professional Modifier Low / Median / High Price $2,025.63 / $5,179.33 / $5,885.60	Professional		$2,025.63	$5,179.33	$5,885.60
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $1,236.35 / $1,831.48 / $2,759.49	Facility		$1,236.35	$1,831.48	$2,759.49
Medica Facility/Professional Facility Modifier Low / Median / High Price $1,236.35 / $2,017.96 / $13,250.00	Facility		$1,236.35	$2,017.96	$13,250.00
Medica Facility/Professional Professional Modifier Low / Median / High Price $1,489.02 / $2,674.61 / $10,776.75	Professional		$1,489.02	$2,674.61	$10,776.75
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 $1,236.35 / $1,822.20 / $2,759.49	Facility		$1,236.35	$1,822.20	$2,759.49
Quartz Facility/Professional Professional Modifier Low / Median / High Price $2,696.85 / $3,286.01 / $4,905.35	Professional		$2,696.85	$3,286.01	$4,905.35
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 $2,602.05 / $6,524.20 / $10,776.75	Professional		$2,602.05	$6,524.20	$10,776.75
Security Health Facility/Professional Professional Modifier Low / Median / High Price $4,655.37 / $4,655.37 / $4,655.37	Professional		$4,655.37	$4,655.37	$4,655.37
Security Health Facility/Professional Professional Modifier Low / Median / High Price $4,504.71 / $7,645.89 / $7,755.54	Professional		$4,504.71	$7,645.89	$7,755.54
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 $1,435.32 / $2,740.22 / $5,910.93	Professional		$1,435.32	$2,740.22	$5,910.93