Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $1,040.00 / $1,040.00 / $1,040.00	Facility		$1,040.00	$1,040.00	$1,040.00
Aetna Facility/Professional Professional Modifier Low / Median / High Price $1,040.00 / $1,040.00 / $1,300.00	Professional		$1,040.00	$1,040.00	$1,300.00
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $1,497.59 / $1,740.45 / $1,805.21	Facility		$1,497.59	$1,740.45	$1,805.21
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $1,161.76 / $2,141.46 / $4,572.47	Professional		$1,161.76	$2,141.46	$4,572.47
Cigna Facility/Professional Facility Modifier Low / Median / High Price $508.14 / $818.04 / $1,159.44	Facility		$508.14	$818.04	$1,159.44
Cigna Facility/Professional Professional Modifier Low / Median / High Price $1,066.90 / $2,079.53 / $2,363.10	Professional		$1,066.90	$2,079.53	$2,363.10
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $1,040.00 / $1,105.00 / $1,537.38	Facility		$1,040.00	$1,105.00	$1,537.38
Medica Facility/Professional Facility Modifier Low / Median / High Price $809.51 / $1,105.00 / $1,537.38	Facility		$809.51	$1,105.00	$1,537.38
Medica Facility/Professional Professional Modifier Low / Median / High Price $1,235.00 / $1,235.00 / $1,976.00	Professional		$1,235.00	$1,235.00	$1,976.00
Molina Facility/Professional Professional Modifier Low / Median / High Price $55.00 / $81.81 / $85.00	Professional		$55.00	$81.81	$85.00
Prevea360 Facility/Professional Facility Modifier Low / Median / High Price $1,040.00 / $1,105.00 / $1,537.38	Facility		$1,040.00	$1,105.00	$1,537.38
Quartz Facility/Professional Professional Modifier Low / Median / High Price $1,395.64 / $3,060.54 / $4,268.00	Professional		$1,395.64	$3,060.54	$4,268.00
Quartz Facility/Professional Facility Modifier Low / Median / High Price $6,867.59 / $6,867.59 / $6,867.59	Facility		$6,867.59	$6,867.59	$6,867.59
Quartz Facility/Professional Professional Modifier Low / Median / High Price $1,066.90 / $5,860.00 / $7,425.58	Professional		$1,066.90	$5,860.00	$7,425.58
United Facility/Professional Professional Modifier Low / Median / High Price $1,235.00 / $1,235.00 / $1,605.50	Professional		$1,235.00	$1,235.00	$1,605.50