Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $2,743.10 / $2,743.10 / $3,828.96	Facility		$2,743.10	$2,743.10	$3,828.96
Aetna Facility/Professional Professional Modifier Low / Median / High Price $2,743.10 / $2,743.10 / $3,428.88	Professional		$2,743.10	$2,743.10	$3,428.88
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $4,060.05 / $4,718.43 / $4,894.00	Facility		$4,060.05	$4,718.43	$4,894.00
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $2,857.40 / $2,914.55 / $10,024.02	Professional		$2,857.40	$2,914.55	$10,024.02
Cigna Facility/Professional Facility Modifier Low / Median / High Price $1,377.66 / $2,217.84 / $3,143.44	Facility		$1,377.66	$2,217.84	$3,143.44
Cigna Facility/Professional Professional Modifier Low / Median / High Price $2,914.55 / $5,578.02 / $6,338.66	Professional		$2,914.55	$5,578.02	$6,338.66
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $2,701.26 / $2,743.10 / $3,697.58	Facility		$2,701.26	$2,743.10	$3,697.58
Medica Facility/Professional Facility Modifier Low / Median / High Price $2,194.62 / $2,743.10 / $3,697.58	Facility		$2,194.62	$2,743.10	$3,697.58
Medica Facility/Professional Professional Modifier Low / Median / High Price $2,857.40 / $2,857.40 / $4,829.66	Professional		$2,857.40	$2,857.40	$4,829.66
Molina Facility/Professional Professional Modifier Low / Median / High Price $50.00 / $65.00 / $10,787.27	Professional		$50.00	$65.00	$10,787.27
Prevea360 Facility/Professional Facility Modifier Low / Median / High Price $2,701.26 / $2,743.10 / $7,003.50	Facility		$2,701.26	$2,743.10	$7,003.50
Quartz Facility/Professional Professional Modifier Low / Median / High Price $107.31 / $7,677.52 / $11,303.76	Professional		$107.31	$7,677.52	$11,303.76
Quartz Facility/Professional Facility Modifier Low / Median / High Price $15,144.20 / $15,144.20 / $15,144.20	Facility		$15,144.20	$15,144.20	$15,144.20
Quartz Facility/Professional Professional Modifier Low / Median / High Price $2,914.55 / $3,634.61 / $13,029.74	Professional		$2,914.55	$3,634.61	$13,029.74
United Facility/Professional Professional Modifier Low / Median / High Price $2,857.40 / $2,857.40 / $3,714.62	Professional		$2,857.40	$2,857.40	$3,714.62