Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $1,340.00 / $1,340.00 / $1,340.00	Facility		$1,340.00	$1,340.00	$1,340.00
Aetna Facility/Professional Professional Modifier Low / Median / High Price $1,340.00 / $1,340.00 / $1,675.00	Professional		$1,340.00	$1,340.00	$1,675.00
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $1,607.52 / $3,109.60 / $6,385.42	Professional		$1,607.52	$3,109.60	$6,385.42
Cigna Facility/Professional Facility Modifier Low / Median / High Price $1,380.10 / $2,708.48 / $4,272.67	Facility		$1,380.10	$2,708.48	$4,272.67
Cigna Facility/Professional Professional Modifier Low / Median / High Price $1,021.63 / $2,720.65 / $3,091.65	Professional		$1,021.63	$2,720.65	$3,091.65
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $1,340.00 / $1,423.75 / $1,988.68	Facility		$1,340.00	$1,423.75	$1,988.68
Medica Facility/Professional Facility Modifier Low / Median / High Price $1,340.00 / $1,482.78 / $1,988.68	Facility		$1,340.00	$1,482.78	$1,988.68
Medica Facility/Professional Professional Modifier Low / Median / High Price $1,675.00 / $1,675.00 / $3,517.50	Professional		$1,675.00	$1,675.00	$3,517.50
Molina Facility/Professional Professional Modifier Low / Median / High Price $50.00 / $65.00 / $5,263.28	Professional		$50.00	$65.00	$5,263.28
Prevea360 Facility/Professional Facility Modifier Low / Median / High Price $1,340.00 / $1,423.75 / $1,988.68	Facility		$1,340.00	$1,423.75	$1,988.68
Quartz Facility/Professional Professional Modifier Low / Median / High Price $2,157.17 / $3,975.05 / $5,520.90	Professional		$2,157.17	$3,975.05	$5,520.90
Quartz Facility/Professional Facility Modifier Low / Median / High Price $8,883.66 / $8,883.66 / $8,883.66	Facility		$8,883.66	$8,883.66	$8,883.66
Quartz Facility/Professional Professional Modifier Low / Median / High Price $1,380.10 / $7,666.65 / $10,274.74	Professional		$1,380.10	$7,666.65	$10,274.74
United Facility/Professional Professional Modifier Low / Median / High Price $1,675.00 / $1,675.00 / $2,512.50	Professional		$1,675.00	$1,675.00	$2,512.50