Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $200.00 / $200.00 / $200.00	Facility		$200.00	$200.00	$200.00
Aetna Facility/Professional Professional Modifier Low / Median / High Price $1,579.83 / $1,579.83 / $1,579.83	Professional		$1,579.83	$1,579.83	$1,579.83
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $838.81 / $1,702.78 / $5,303.46	Professional		$838.81	$1,702.78	$5,303.46
Cigna Facility/Professional Facility Modifier Low / Median / High Price $2,056.36 / $2,403.01 / $3,686.29	Facility		$2,056.36	$2,403.01	$3,686.29
Cigna Facility/Professional Professional Modifier Low / Median / High Price $1,242.66 / $3,319.20 / $3,771.81	Professional		$1,242.66	$3,319.20	$3,771.81
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $824.34 / $1,247.33 / $1,626.90	Facility		$824.34	$1,247.33	$1,626.90
Medica Facility/Professional Facility Modifier Low / Median / High Price $851.30 / $1,247.33 / $1,494.62	Facility		$851.30	$1,247.33	$1,494.62
Medica Facility/Professional Professional Modifier Low / Median / High Price $158.58 / $1,627.85 / $5,609.51	Professional		$158.58	$1,627.85	$5,609.51
Molina Facility/Professional Professional Modifier Low / Median / High Price $65.00 / $85.00 / $2,968.18	Professional		$65.00	$85.00	$2,968.18
Prevea360 Facility/Professional Facility Modifier Low / Median / High Price $824.34 / $1,247.33 / $1,626.90	Facility		$824.34	$1,247.33	$1,626.90
Quartz Facility/Professional Professional Modifier Low / Median / High Price $1,503.90 / $2,196.81 / $3,063.50	Professional		$1,503.90	$2,196.81	$3,063.50
Quartz Facility/Professional Facility Modifier Low / Median / High Price $4,214.47 / $4,214.47 / $4,214.47	Facility		$4,214.47	$4,214.47	$4,214.47
Quartz Facility/Professional Professional Modifier Low / Median / High Price $3,381.71 / $4,317.89 / $5,609.51	Professional		$3,381.71	$4,317.89	$5,609.51
Security Health Facility/Professional Professional Modifier Low / Median / High Price $2,429.48 / $2,429.48 / $2,429.48	Professional		$2,429.48	$2,429.48	$2,429.48
Security Health Facility/Professional Professional Modifier Low / Median / High Price $3,373.12 / $4,633.35 / $4,633.35	Professional		$3,373.12	$4,633.35	$4,633.35
United Facility/Professional Professional Modifier Low / Median / High Price $223.08 / $1,095.24 / $3,057.07	Professional		$223.08	$1,095.24	$3,057.07