Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $3,715.20 / $3,715.20 / $3,715.20	Facility		$3,715.20	$3,715.20	$3,715.20
Aetna Facility/Professional Professional Modifier Low / Median / High Price $3,715.20 / $3,715.20 / $4,644.00	Professional		$3,715.20	$3,715.20	$4,644.00
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $3,542.03 / $4,116.41 / $4,269.58	Facility		$3,542.03	$4,116.41	$4,269.58
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $3,870.00 / $5,751.04 / $19,587.20	Professional		$3,870.00	$5,751.04	$19,587.20
Cigna Facility/Professional Facility Modifier Low / Median / High Price $3,947.40 / $10,741.76 / $16,945.28	Facility		$3,947.40	$10,741.76	$16,945.28
Cigna Facility/Professional Professional Modifier Low / Median / High Price $3,947.40 / $10,899.60 / $12,385.91	Professional		$3,947.40	$10,899.60	$12,385.91
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $3,715.20 / $4,644.00 / $6,810.48	Facility		$3,715.20	$4,644.00	$6,810.48
Medica Facility/Professional Facility Modifier Low / Median / High Price $1,914.61 / $3,947.40 / $6,810.48	Facility		$1,914.61	$3,947.40	$6,810.48
Medica Facility/Professional Professional Modifier Low / Median / High Price $3,870.00 / $3,870.00 / $8,127.00	Professional		$3,870.00	$3,870.00	$8,127.00
Molina Facility/Professional Professional Modifier Low / Median / High Price $55.00 / $85.00 / $21,406.40	Professional		$55.00	$85.00	$21,406.40
Prevea360 Facility/Professional Facility Modifier Low / Median / High Price $3,715.20 / $3,947.40 / $6,810.48	Facility		$3,715.20	$3,947.40	$6,810.48
Quartz Facility/Professional Professional Modifier Low / Median / High Price $7,189.32 / $15,765.75 / $21,985.70	Professional		$7,189.32	$15,765.75	$21,985.70
Quartz Facility/Professional Facility Modifier Low / Median / High Price $35,376.98 / $35,376.98 / $35,376.98	Facility		$35,376.98	$35,376.98	$35,376.98
Quartz Facility/Professional Professional Modifier Low / Median / High Price $3,947.40 / $28,651.91 / $38,920.43	Professional		$3,947.40	$28,651.91	$38,920.43
United Facility/Professional Professional Modifier Low / Median / High Price $3,870.00 / $3,870.00 / $5,504.92	Professional		$3,870.00	$3,870.00	$5,504.92