Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $4,800.00 / $4,800.00 / $4,800.00	Facility		$4,800.00	$4,800.00	$4,800.00
Aetna Facility/Professional Professional Modifier Low / Median / High Price $4,800.00 / $4,800.00 / $6,000.00	Professional		$4,800.00	$4,800.00	$6,000.00
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $3,816.44 / $4,435.32 / $4,600.35	Facility		$3,816.44	$4,435.32	$4,600.35
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $5,000.00 / $5,000.00 / $5,000.00	Professional		$5,000.00	$5,000.00	$5,000.00
Cigna Facility/Professional Facility Modifier Low / Median / High Price $5,100.00 / $15,019.01 / $23,692.71	Facility		$5,100.00	$15,019.01	$23,692.71
Cigna Facility/Professional Professional Modifier Low / Median / High Price $5,100.00 / $5,500.13 / $6,985.16	Professional		$5,100.00	$5,500.13	$6,985.16
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $4,800.00 / $4,800.00 / $6,000.00	Facility		$4,800.00	$4,800.00	$6,000.00
Medica Facility/Professional Facility Modifier Low / Median / High Price $2,062.94 / $4,800.00 / $6,000.00	Facility		$2,062.94	$4,800.00	$6,000.00
Medica Facility/Professional Professional Modifier Low / Median / High Price $5,000.00 / $5,000.00 / $10,500.00	Professional		$5,000.00	$5,000.00	$10,500.00
Molina Facility/Professional Professional Modifier Low / Median / High Price $50.00 / $58.40 / $85.00	Professional		$50.00	$58.40	$85.00
Prevea360 Facility/Professional Facility Modifier Low / Median / High Price $4,800.00 / $4,800.00 / $6,000.00	Facility		$4,800.00	$4,800.00	$6,000.00
Quartz Facility/Professional Facility Modifier Low / Median / High Price $28,500.00 / $28,500.00 / $28,500.00	Facility		$28,500.00	$28,500.00	$28,500.00
Quartz Facility/Professional Professional Modifier Low / Median / High Price $5,100.00 / $6,360.00 / $22,800.00	Professional		$5,100.00	$6,360.00	$22,800.00
United Facility/Professional Professional Modifier Low / Median / High Price $5,000.00 / $5,000.00 / $6,500.00	Professional		$5,000.00	$5,000.00	$6,500.00