Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $1,200.00 / $1,200.00 / $1,200.00	Facility		$1,200.00	$1,200.00	$1,200.00
Aetna Facility/Professional Professional Modifier Low / Median / High Price $1,200.00 / $1,200.00 / $1,275.00	Professional		$1,200.00	$1,200.00	$1,275.00
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $1,011.13 / $2,065.80 / $4,273.89	Professional		$1,011.13	$2,065.80	$4,273.89
Cigna Facility/Professional Facility Modifier Low / Median / High Price $1,275.00 / $1,275.00 / $1,275.00	Facility		$1,275.00	$1,275.00	$1,275.00
Cigna Facility/Professional Professional Modifier Low / Median / High Price $1,275.00 / $1,275.00 / $1,652.10	Professional		$1,275.00	$1,275.00	$1,652.10
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $1,200.00 / $1,275.00 / $2,634.22	Facility		$1,200.00	$1,275.00	$2,634.22
Medica Facility/Professional Facility Modifier Low / Median / High Price $1,200.00 / $1,275.00 / $2,634.22	Facility		$1,200.00	$1,275.00	$2,634.22
Medica Facility/Professional Professional Modifier Low / Median / High Price $1,250.00 / $1,250.00 / $2,625.00	Professional		$1,250.00	$1,250.00	$2,625.00
Molina Facility/Professional Professional Modifier Low / Median / High Price $50.00 / $70.00 / $85.00	Professional		$50.00	$70.00	$85.00
Prevea360 Facility/Professional Facility Modifier Low / Median / High Price $1,200.00 / $1,275.00 / $2,634.22	Facility		$1,200.00	$1,275.00	$2,634.22
Quartz Facility/Professional Professional Modifier Low / Median / High Price $1,463.47 / $2,483.27 / $3,866.72	Professional		$1,463.47	$2,483.27	$3,866.72
Quartz Facility/Professional Facility Modifier Low / Median / High Price $1,275.00 / $1,425.00 / $5,130.00	Facility		$1,275.00	$1,425.00	$5,130.00
Quartz Facility/Professional Professional Modifier Low / Median / High Price $1,275.00 / $1,590.00 / $5,250.00	Professional		$1,275.00	$1,590.00	$5,250.00
United Facility/Professional Professional Modifier Low / Median / High Price $1,250.00 / $1,250.00 / $1,575.00	Professional		$1,250.00	$1,250.00	$1,575.00