Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $4,904.07 / $4,904.07 / $4,904.07	Facility		$4,904.07	$4,904.07	$4,904.07
Aetna Facility/Professional Professional Modifier Low / Median / High Price $4,904.07 / $4,904.07 / $6,130.09	Professional		$4,904.07	$4,904.07	$6,130.09
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $3,838.40 / $4,460.84 / $4,626.83	Facility		$3,838.40	$4,460.84	$4,626.83
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $2,274.29 / $5,108.41 / $7,817.45	Professional		$2,274.29	$5,108.41	$7,817.45
Cigna Facility/Professional Facility Modifier Low / Median / High Price $5,210.58 / $6,941.70 / $10,950.63	Facility		$5,210.58	$6,941.70	$10,950.63
Cigna Facility/Professional Professional Modifier Low / Median / High Price $2,618.39 / $4,626.08 / $5,210.58	Professional		$2,618.39	$4,626.08	$5,210.58
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $2,218.69 / $4,904.07 / $6,130.09	Facility		$2,218.69	$4,904.07	$6,130.09
Medica Facility/Professional Facility Modifier Low / Median / High Price $2,074.81 / $4,775.28 / $6,130.09	Facility		$2,074.81	$4,775.28	$6,130.09
Medica Facility/Professional Professional Modifier Low / Median / High Price $5,108.41 / $5,108.41 / $8,173.46	Professional		$5,108.41	$5,108.41	$8,173.46
Molina Facility/Professional Professional Modifier Low / Median / High Price $50.00 / $65.00 / $27,550.36	Professional		$50.00	$65.00	$27,550.36
Prevea360 Facility/Professional Facility Modifier Low / Median / High Price $2,218.69 / $4,904.07 / $6,130.09	Facility		$2,218.69	$4,904.07	$6,130.09
Quartz Facility/Professional Professional Modifier Low / Median / High Price $2,478.63 / $5,166.93 / $7,607.38	Professional		$2,478.63	$5,166.93	$7,607.38
Quartz Facility/Professional Facility Modifier Low / Median / High Price $21,893.18 / $21,893.18 / $21,893.18	Facility		$21,893.18	$21,893.18	$21,893.18
Quartz Facility/Professional Professional Modifier Low / Median / High Price $5,210.58 / $6,497.90 / $22,185.08	Professional		$5,210.58	$6,497.90	$22,185.08
United Facility/Professional Professional Modifier Low / Median / High Price $5,108.41 / $5,108.41 / $6,640.93	Professional		$5,108.41	$5,108.41	$6,640.93