Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $4,073.80 / $4,073.80 / $4,073.80	Facility		$4,073.80	$4,073.80	$4,073.80
Aetna Facility/Professional Professional Modifier Low / Median / High Price $4,073.80 / $4,168.69 / $4,265.80	Professional		$4,073.80	$4,168.69	$4,265.80
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $3,801.89 / $4,168.69 / $12,022.64	Professional		$3,801.89	$4,168.69	$12,022.64
Cigna Facility/Professional Facility Modifier Low / Median / High Price $4,265.80 / $4,265.80 / $4,265.80	Facility		$4,265.80	$4,265.80	$4,265.80
Cigna Facility/Professional Professional Modifier Low / Median / High Price $4,265.80 / $6,918.31 / $7,762.47	Professional		$4,265.80	$6,918.31	$7,762.47
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $3,715.35 / $4,168.69 / $5,370.32	Facility		$3,715.35	$4,168.69	$5,370.32
Medica Facility/Professional Facility Modifier Low / Median / High Price $3,715.35 / $4,265.80 / $5,370.32	Facility		$3,715.35	$4,265.80	$5,370.32
Medica Facility/Professional Professional Modifier Low / Median / High Price $4,168.69 / $4,168.69 / $17,782.79	Professional		$4,168.69	$4,168.69	$17,782.79
Molina Facility/Professional Professional Modifier Low / Median / High Price $50.12 / $54.95 / $85.11	Professional		$50.12	$54.95	$85.11
Quartz Facility/Professional Professional Modifier Low / Median / High Price $5,370.32 / $11,481.54 / $21,379.62	Professional		$5,370.32	$11,481.54	$21,379.62
Quartz Facility/Professional Facility Modifier Low / Median / High Price $4,265.80 / $4,265.80 / $15,135.61	Facility		$4,265.80	$4,265.80	$15,135.61
Quartz Facility/Professional Professional Modifier Low / Median / High Price $4,265.80 / $5,370.32 / $22,908.68	Professional		$4,265.80	$5,370.32	$22,908.68
United Facility/Professional Facility Modifier Low / Median / High Price $4,677.35 / $4,677.35 / $4,677.35	Facility		$4,677.35	$4,677.35	$4,677.35
United Facility/Professional Professional Modifier Low / Median / High Price $4,168.69 / $4,168.69 / $5,754.40	Professional		$4,168.69	$4,168.69	$5,754.40