Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $1,894.00 / $1,894.00 / $17,823.00	Facility		$1,894.00	$1,894.00	$17,823.00
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $1,139.00 / $2,479.00 / $4,441.52	Facility		$1,139.00	$2,479.00	$4,441.52
Medica Facility/Professional Facility Modifier Low / Median / High Price $916.00 / $1,449.00 / $2,090.40	Facility		$916.00	$1,449.00	$2,090.40
Medica Facility/Professional Professional Modifier Low / Median / High Price $4,377.56 / $4,377.56 / $4,377.56	Professional		$4,377.56	$4,377.56	$4,377.56
Molina Facility/Professional Professional Modifier Low / Median / High Price $50.00 / $65.00 / $85.00	Professional		$50.00	$65.00	$85.00
Quartz Facility/Professional Professional Modifier Low / Median / High Price $4,377.56 / $4,377.56 / $4,377.56	Professional		$4,377.56	$4,377.56	$4,377.56
United Facility/Professional Facility Modifier Low / Median / High Price $1,034.00 / $1,423.00 / $2,202.90	Facility		$1,034.00	$1,423.00	$2,202.90