Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $1,296.00 / $1,296.00 / $1,296.00	Facility		$1,296.00	$1,296.00	$1,296.00
Aetna Facility/Professional Professional Modifier Low / Median / High Price $1,296.00 / $1,296.00 / $1,377.00	Professional		$1,296.00	$1,296.00	$1,377.00
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $1,077.54 / $2,214.53 / $4,581.59	Professional		$1,077.54	$2,214.53	$4,581.59
Cigna Facility/Professional Facility Modifier Low / Median / High Price $1,377.00 / $1,377.00 / $1,377.00	Facility		$1,377.00	$1,377.00	$1,377.00
Cigna Facility/Professional Professional Modifier Low / Median / High Price $1,377.00 / $1,377.00 / $1,842.78	Professional		$1,377.00	$1,377.00	$1,842.78
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $1,296.00 / $1,377.00 / $2,845.20	Facility		$1,296.00	$1,377.00	$2,845.20
Medica Facility/Professional Facility Modifier Low / Median / High Price $1,296.00 / $1,377.00 / $2,845.20	Facility		$1,296.00	$1,377.00	$2,845.20
Medica Facility/Professional Professional Modifier Low / Median / High Price $1,350.00 / $1,350.00 / $2,835.00	Professional		$1,350.00	$1,350.00	$2,835.00
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 $1,296.00 / $1,377.00 / $2,845.20	Facility		$1,296.00	$1,377.00	$2,845.20
Quartz Facility/Professional Professional Modifier Low / Median / High Price $1,632.38 / $2,769.88 / $4,313.01	Professional		$1,632.38	$2,769.88	$4,313.01
Quartz Facility/Professional Facility Modifier Low / Median / High Price $1,377.00 / $1,539.00 / $5,737.50	Facility		$1,377.00	$1,539.00	$5,737.50
Quartz Facility/Professional Professional Modifier Low / Median / High Price $1,377.00 / $1,717.20 / $5,814.00	Professional		$1,377.00	$1,717.20	$5,814.00
United Facility/Professional Professional Modifier Low / Median / High Price $1,350.00 / $1,350.00 / $1,701.00	Professional		$1,350.00	$1,350.00	$1,701.00