Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $1,257.49 / $3,038.82 / $14,482.00	Facility		$1,257.49	$3,038.82	$14,482.00
Aetna Facility/Professional Facility Modifier 54 Low / Median / High Price $943.12 / $943.12 / $2,279.12	Facility	54	$943.12	$943.12	$2,279.12
Aetna Facility/Professional Professional Modifier Low / Median / High Price $616.03 / $1,257.49 / $1,495.20	Professional		$616.03	$1,257.49	$1,495.20
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $2,740.00 / $4,780.00 / $7,344.00	Facility		$2,740.00	$4,780.00	$7,344.00
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $753.27 / $1,623.59 / $3,813.45	Professional		$753.27	$1,623.59	$3,813.45
Cigna Facility/Professional Facility Modifier Low / Median / High Price $2,225.77 / $2,600.98 / $4,195.30	Facility		$2,225.77	$2,600.98	$4,195.30
Cigna Facility/Professional Professional Modifier Low / Median / High Price $949.30 / $2,013.83 / $3,017.05	Professional		$949.30	$2,013.83	$3,017.05
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $757.81 / $1,054.58 / $1,533.00	Facility		$757.81	$1,054.58	$1,533.00
Medica Facility/Professional Facility Modifier Low / Median / High Price $799.19 / $4,103.00 / $8,384.00	Facility		$799.19	$4,103.00	$8,384.00
Medica Facility/Professional Professional Modifier Low / Median / High Price $757.81 / $1,607.13 / $6,198.56	Professional		$757.81	$1,607.13	$6,198.56
Molina Facility/Professional Professional Modifier Low / Median / High Price $62.75 / $431.48 / $1,374.18	Professional		$62.75	$431.48	$1,374.18
Prevea360 Facility/Professional Facility Modifier Low / Median / High Price $757.81 / $1,054.58 / $1,697.83	Facility		$757.81	$1,054.58	$1,697.83
Quartz Facility/Professional Professional Modifier Low / Median / High Price $1,472.40 / $1,943.57 / $2,758.79	Professional		$1,472.40	$1,943.57	$2,758.79
Quartz Facility/Professional Facility Modifier Low / Median / High Price $6,887.55 / $6,887.55 / $6,887.55	Facility		$6,887.55	$6,887.55	$6,887.55
Quartz Facility/Professional Facility Modifier 54 Low / Median / High Price $4,569.92 / $4,569.92 / $4,569.92	Facility	54	$4,569.92	$4,569.92	$4,569.92
Quartz Facility/Professional Professional Modifier Low / Median / High Price $1,380.35 / $3,861.80 / $6,198.56	Professional		$1,380.35	$3,861.80	$6,198.56
Security Health Facility/Professional Professional Modifier Low / Median / High Price $1,731.37 / $5,101.49 / $8,109.71	Professional		$1,731.37	$5,101.49	$8,109.71
United Facility/Professional Facility Modifier Low / Median / High Price $4,614.00 / $6,477.00 / $8,384.00	Facility		$4,614.00	$6,477.00	$8,384.00
United Facility/Professional Professional Modifier Low / Median / High Price $811.66 / $1,652.40 / $3,384.87	Professional		$811.66	$1,652.40	$3,384.87