Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $991.87 / $991.87 / $991.87	Facility		$991.87	$991.87	$991.87
Aetna Facility/Professional Professional Modifier Low / Median / High Price $991.87 / $1,029.06 / $1,070.64	Professional		$991.87	$1,029.06	$1,070.64
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $946.37 / $1,099.83 / $1,140.76	Facility		$946.37	$1,099.83	$1,140.76
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $1,033.20 / $1,033.20 / $1,033.20	Professional		$1,033.20	$1,033.20	$1,033.20
Cigna Facility/Professional Facility Modifier Low / Median / High Price $1,696.94 / $3,104.36 / $4,399.95	Facility		$1,696.94	$3,104.36	$4,399.95
Cigna Facility/Professional Professional Modifier Low / Median / High Price $1,053.85 / $1,053.85 / $1,614.84	Professional		$1,053.85	$1,053.85	$1,614.84
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $991.87 / $1,004.27 / $1,477.89	Facility		$991.87	$1,004.27	$1,477.89
Medica Facility/Professional Facility Modifier Low / Median / High Price $991.87 / $1,053.85 / $5,155.00	Facility		$991.87	$1,053.85	$5,155.00
Medica Facility/Professional Professional Modifier Low / Median / High Price $1,033.20 / $1,033.20 / $2,169.71	Professional		$1,033.20	$1,033.20	$2,169.71
Molina Facility/Professional Professional Modifier Low / Median / High Price $50.00 / $70.00 / $3,514.57	Professional		$50.00	$70.00	$3,514.57
Prevea360 Facility/Professional Facility Modifier Low / Median / High Price $991.87 / $991.87 / $1,477.89	Facility		$991.87	$991.87	$1,477.89
Quartz Facility/Professional Professional Modifier Low / Median / High Price $5,900.00 / $5,900.00 / $5,900.00	Professional		$5,900.00	$5,900.00	$5,900.00
Quartz Facility/Professional Facility Modifier Low / Median / High Price $1,053.85 / $4,124.00 / $5,155.00	Facility		$1,053.85	$4,124.00	$5,155.00
Quartz Facility/Professional Professional Modifier Low / Median / High Price $1,053.85 / $1,251.65 / $4,487.04	Professional		$1,053.85	$1,251.65	$4,487.04
United Facility/Professional Professional Modifier Low / Median / High Price $1,033.20 / $1,033.20 / $1,239.83	Professional		$1,033.20	$1,033.20	$1,239.83