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 $2,378.19 / $2,870.13 / $2,870.13	Professional		$2,378.19	$2,870.13	$2,870.13
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $976.49 / $1,982.27 / $6,177.54	Professional		$976.49	$1,982.27	$6,177.54
Cigna Facility/Professional Facility Modifier Low / Median / High Price $2,506.92 / $2,929.53 / $4,493.97	Facility		$2,506.92	$2,929.53	$4,493.97
Cigna Facility/Professional Professional Modifier Low / Median / High Price $1,514.87 / $4,045.20 / $4,596.81	Professional		$1,514.87	$4,045.20	$4,596.81
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $960.00 / $1,452.11 / $1,913.66	Facility		$960.00	$1,452.11	$1,913.66
Medica Facility/Professional Facility Modifier Low / Median / High Price $1,022.78 / $1,452.11 / $2,495.77	Facility		$1,022.78	$1,452.11	$2,495.77
Medica Facility/Professional Professional Modifier Low / Median / High Price $177.48 / $1,983.93 / $7,344.00	Professional		$177.48	$1,983.93	$7,344.00
Molina Facility/Professional Professional Modifier Low / Median / High Price $65.00 / $88.58 / $3,241.95	Professional		$65.00	$88.58	$3,241.95
Prevea360 Facility/Professional Facility Modifier Low / Median / High Price $960.00 / $1,452.11 / $1,913.66	Facility		$960.00	$1,452.11	$1,913.66
Quartz Facility/Professional Professional Modifier Low / Median / High Price $1,753.92 / $2,562.02 / $3,572.80	Professional		$1,753.92	$2,562.02	$3,572.80
Quartz Facility/Professional Facility Modifier Low / Median / High Price $4,915.35 / $4,915.35 / $4,915.35	Facility		$4,915.35	$4,915.35	$4,915.35
Quartz Facility/Professional Professional Modifier Low / Median / High Price $3,944.67 / $5,003.50 / $7,344.00	Professional		$3,944.67	$5,003.50	$7,344.00
Security Health Facility/Professional Professional Modifier Low / Median / High Price $2,960.88 / $2,960.88 / $2,960.88	Professional		$2,960.88	$2,960.88	$2,960.88
Security Health Facility/Professional Professional Modifier Low / Median / High Price $4,110.93 / $5,646.81 / $5,646.81	Professional		$4,110.93	$5,646.81	$5,646.81
United Facility/Professional Facility Modifier Low / Median / High Price $3,261.40 / $3,261.40 / $4,205.49	Facility		$3,261.40	$3,261.40	$4,205.49
United Facility/Professional Professional Modifier Low / Median / High Price $250.41 / $1,679.18 / $3,934.83	Professional		$250.41	$1,679.18	$3,934.83