Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $1,570.38 / $3,780.75 / $14,482.00	Facility		$1,570.38	$3,780.75	$14,482.00
Aetna Facility/Professional Professional Modifier Low / Median / High Price $765.90 / $1,123.95 / $3,272.84	Professional		$765.90	$1,123.95	$3,272.84
Aetna Facility/Professional Professional Modifier 50 Low / Median / High Price $1,241.33 / $6,841.86 / $6,841.86	Professional	50	$1,241.33	$6,841.86	$6,841.86
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $5,060.00 / $7,344.00 / $10,517.23	Facility		$5,060.00	$7,344.00	$10,517.23
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $923.08 / $2,027.57 / $4,934.29	Professional		$923.08	$2,027.57	$4,934.29
Anthem BCBS Facility/Professional Professional Modifier 50 Low / Median / High Price $1,384.62 / $3,100.99 / $7,401.43	Professional	50	$1,384.62	$3,100.99	$7,401.43
Cigna Facility/Professional Facility Modifier Low / Median / High Price $2,772.75 / $3,240.17 / $5,226.28	Facility		$2,772.75	$3,240.17	$5,226.28
Cigna Facility/Professional Professional Modifier Low / Median / High Price $1,181.08 / $2,505.53 / $5,061.89	Professional		$1,181.08	$2,505.53	$5,061.89
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $942.83 / $1,292.31 / $1,911.00	Facility		$942.83	$1,292.31	$1,911.00
Medica Facility/Professional Facility Modifier Low / Median / High Price $998.91 / $4,240.00 / $11,598.00	Facility		$998.91	$4,240.00	$11,598.00
Medica Facility/Professional Professional Modifier Low / Median / High Price $942.83 / $1,989.04 / $7,723.36	Professional		$942.83	$1,989.04	$7,723.36
Molina Facility/Professional Professional Modifier Low / Median / High Price $91.28 / $577.60 / $1,671.18	Professional		$91.28	$577.60	$1,671.18
Prevea360 Facility/Professional Facility Modifier Low / Median / High Price $942.83 / $1,292.31 / $2,112.44	Facility		$942.83	$1,292.31	$2,112.44
Quartz Facility/Professional Professional Modifier Low / Median / High Price $1,831.80 / $2,417.98 / $3,609.56	Professional		$1,831.80	$2,417.98	$3,609.56
Quartz Facility/Professional Facility Modifier Low / Median / High Price $9,001.70 / $9,001.70 / $9,001.70	Facility		$9,001.70	$9,001.70	$9,001.70
Quartz Facility/Professional Professional Modifier Low / Median / High Price $1,719.72 / $4,779.50 / $7,723.36	Professional		$1,719.72	$4,779.50	$7,723.36
Security Health Facility/Professional Professional Modifier Low / Median / High Price $2,254.81 / $6,380.68 / $10,103.53	Professional		$2,254.81	$6,380.68	$10,103.53
United Facility/Professional Facility Modifier Low / Median / High Price $6,241.00 / $9,837.00 / $12,062.00	Facility		$6,241.00	$9,837.00	$12,062.00
United Facility/Professional Professional Modifier Low / Median / High Price $942.83 / $1,853.86 / $4,189.22	Professional		$942.83	$1,853.86	$4,189.22