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 $2,321.98 / $2,321.98 / $2,321.98	Professional		$2,321.98	$2,321.98	$2,321.98
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $1,080.47 / $2,193.35 / $6,834.64	Professional		$1,080.47	$2,193.35	$6,834.64
Cigna Facility/Professional Facility Modifier Low / Median / High Price $2,669.12 / $3,119.07 / $4,784.74	Facility		$2,669.12	$3,119.07	$4,784.74
Cigna Facility/Professional Professional Modifier Low / Median / High Price $1,613.31 / $4,307.35 / $4,894.71	Professional		$1,613.31	$4,307.35	$4,894.71
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $1,062.08 / $1,606.72 / $2,127.40	Facility		$1,062.08	$1,606.72	$2,127.40
Medica Facility/Professional Facility Modifier Low / Median / High Price $1,104.74 / $1,606.72 / $3,261.40	Facility		$1,104.74	$1,606.72	$3,261.40
Medica Facility/Professional Professional Modifier Low / Median / High Price $1,065.88 / $2,244.82 / $11,427.00	Professional		$1,065.88	$2,244.82	$11,427.00
Molina Facility/Professional Professional Modifier Low / Median / High Price $55.00 / $85.00 / $3,519.65	Professional		$55.00	$85.00	$3,519.65
Prevea360 Facility/Professional Facility Modifier Low / Median / High Price $964.69 / $1,606.72 / $2,127.40	Facility		$964.69	$1,606.72	$2,127.40
Quartz Facility/Professional Professional Modifier Low / Median / High Price $1,938.60 / $2,831.79 / $3,949.00	Professional		$1,938.60	$2,831.79	$3,949.00
Quartz Facility/Professional Facility Modifier Low / Median / High Price $9,522.00 / $9,522.00 / $9,522.00	Facility		$9,522.00	$9,522.00	$9,522.00
Quartz Facility/Professional Professional Modifier Low / Median / High Price $4,680.64 / $5,558.95 / $11,427.00	Professional		$4,680.64	$5,558.95	$11,427.00
Security Health Facility/Professional Professional Modifier Low / Median / High Price $3,152.76 / $3,152.76 / $3,152.76	Professional		$3,152.76	$3,152.76	$3,152.76
Security Health Facility/Professional Professional Modifier Low / Median / High Price $4,377.32 / $6,012.75 / $6,012.75	Professional		$4,377.32	$6,012.75	$6,012.75
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 $1,058.58 / $2,112.48 / $4,189.78	Professional		$1,058.58	$2,112.48	$4,189.78