Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $1,762.60 / $4,339.18 / $14,482.00	Facility		$1,762.60	$4,339.18	$14,482.00
Aetna Facility/Professional Facility Modifier 54 Low / Median / High Price $1,321.95 / $1,321.95 / $3,254.39	Facility	54	$1,321.95	$1,321.95	$3,254.39
Aetna Facility/Professional Professional Modifier Low / Median / High Price $1,091.43 / $1,762.60 / $4,339.18	Professional		$1,091.43	$1,762.60	$4,339.18
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $6,538.00 / $9,948.00 / $15,579.70	Facility		$6,538.00	$9,948.00	$15,579.70
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $1,159.84 / $2,275.75 / $5,489.97	Professional		$1,159.84	$2,275.75	$5,489.97
Cigna Facility/Professional Facility Modifier Low / Median / High Price $3,109.77 / $3,634.01 / $5,861.52	Facility		$3,109.77	$3,634.01	$5,861.52
Cigna Facility/Professional Professional Modifier Low / Median / High Price $1,344.04 / $2,851.20 / $4,252.93	Professional		$1,344.04	$2,851.20	$4,252.93
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $1,136.64 / $1,677.24 / $2,312.75	Facility		$1,136.64	$1,677.24	$2,312.75
Medica Facility/Professional Facility Modifier Low / Median / High Price $1,298.51 / $7,301.00 / $15,702.00	Facility		$1,298.51	$7,301.00	$15,702.00
Medica Facility/Professional Professional Modifier Low / Median / High Price $1,136.57 / $2,314.40 / $8,135.68	Professional		$1,136.57	$2,314.40	$8,135.68
Molina Facility/Professional Professional Modifier Low / Median / High Price $115.96 / $667.40 / $1,956.68	Professional		$115.96	$667.40	$1,956.68
Prevea360 Facility/Professional Facility Modifier Low / Median / High Price $1,136.64 / $1,677.24 / $2,403.66	Facility		$1,136.64	$1,677.24	$2,403.66
Quartz Facility/Professional Professional Modifier Low / Median / High Price $2,103.00 / $2,775.96 / $3,940.32	Professional		$2,103.00	$2,775.96	$3,940.32
Quartz Facility/Professional Facility Modifier Low / Median / High Price $11,879.05 / $11,879.05 / $11,879.05	Facility		$11,879.05	$11,879.05	$11,879.05
Quartz Facility/Professional Facility Modifier 54 Low / Median / High Price $7,881.75 / $7,881.75 / $7,881.75	Facility	54	$7,881.75	$7,881.75	$7,881.75
Quartz Facility/Professional Professional Modifier Low / Median / High Price $1,852.76 / $5,740.00 / $8,792.16	Professional		$1,852.76	$5,740.00	$8,792.16
Security Health Facility/Professional Professional Modifier Low / Median / High Price $2,798.92 / $6,106.73 / $11,431.67	Professional		$2,798.92	$6,106.73	$11,431.67
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 $1,165.40 / $2,388.76 / $5,031.10	Professional		$1,165.40	$2,388.76	$5,031.10