Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $2,488.32 / $4,221.54 / $5,396.49	Facility		$2,488.32	$4,221.54	$5,396.49
Aetna Facility/Professional Professional Modifier Low / Median / High Price $2,488.32 / $2,813.52 / $4,602.39	Professional		$2,488.32	$2,813.52	$4,602.39
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $2,567.84 / $2,984.24 / $3,095.28	Facility		$2,567.84	$2,984.24	$3,095.28
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $2,592.00 / $2,592.00 / $2,643.84	Professional		$2,592.00	$2,592.00	$2,643.84
Cigna Facility/Professional Facility Modifier Low / Median / High Price $2,643.84 / $7,412.74 / $11,693.70	Facility		$2,643.84	$7,412.74	$11,693.70
Cigna Facility/Professional Professional Modifier Low / Median / High Price $2,643.84 / $2,714.63 / $3,393.28	Professional		$2,643.84	$2,714.63	$3,393.28
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $2,488.32 / $2,643.84 / $2,961.60	Facility		$2,488.32	$2,643.84	$2,961.60
Medica Facility/Professional Facility Modifier Low / Median / High Price $1,388.02 / $2,517.36 / $2,961.60	Facility		$1,388.02	$2,517.36	$2,961.60
Medica Facility/Professional Professional Modifier Low / Median / High Price $2,592.00 / $2,592.00 / $4,147.20	Professional		$2,592.00	$2,592.00	$4,147.20
Molina Facility/Professional Professional Modifier Low / Median / High Price $50.00 / $65.00 / $8,958.84	Professional		$50.00	$65.00	$8,958.84
Prevea360 Facility/Professional Facility Modifier Low / Median / High Price $2,488.32 / $2,643.84 / $2,961.60	Facility		$2,488.32	$2,643.84	$2,961.60
Quartz Facility/Professional Facility Modifier Low / Median / High Price $11,106.00 / $11,106.00 / $11,106.00	Facility		$11,106.00	$11,106.00	$11,106.00
Quartz Facility/Professional Professional Modifier Low / Median / High Price $2,643.84 / $3,139.30 / $11,254.08	Professional		$2,643.84	$3,139.30	$11,254.08
United Facility/Professional Professional Modifier Low / Median / High Price $2,592.00 / $2,592.00 / $3,369.60	Professional		$2,592.00	$2,592.00	$3,369.60