Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $3,600.00 / $3,600.00 / $8,028.00	Facility		$3,600.00	$3,600.00	$8,028.00
Aetna Facility/Professional Professional Modifier Low / Median / High Price $3,600.00 / $3,600.00 / $4,500.00	Professional		$3,600.00	$3,600.00	$4,500.00
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $7,670.73 / $8,914.62 / $9,246.34	Facility		$7,670.73	$8,914.62	$9,246.34
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $401.29 / $1,849.18 / $3,750.00	Professional		$401.29	$1,849.18	$3,750.00
Cigna Facility/Professional Facility Modifier Low / Median / High Price $2,680.08 / $4,314.56 / $6,115.23	Facility		$2,680.08	$4,314.56	$6,115.23
Cigna Facility/Professional Professional Modifier Low / Median / High Price $1,871.77 / $2,673.48 / $3,825.00	Professional		$1,871.77	$2,673.48	$3,825.00
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $1,512.47 / $3,600.00 / $4,500.00	Facility		$1,512.47	$3,600.00	$4,500.00
DeanCare Facility/Professional Professional Modifier Low / Median / High Price $320.66 / $320.66 / $320.66	Professional		$320.66	$320.66	$320.66
Medica Facility/Professional Facility Modifier Low / Median / High Price $1,512.47 / $3,600.00 / $4,500.00	Facility		$1,512.47	$3,600.00	$4,500.00
Medica Facility/Professional Professional Modifier Low / Median / High Price $3,750.00 / $3,750.00 / $7,875.00	Professional		$3,750.00	$3,750.00	$7,875.00
Molina Facility/Professional Professional Modifier Low / Median / High Price $55.00 / $85.00 / $15,088.35	Professional		$55.00	$85.00	$15,088.35
Prevea360 Facility/Professional Facility Modifier Low / Median / High Price $1,512.47 / $3,600.00 / $4,500.00	Facility		$1,512.47	$3,600.00	$4,500.00
Prevea360 Facility/Professional Professional Modifier Low / Median / High Price $320.66 / $320.66 / $320.66	Professional		$320.66	$320.66	$320.66
Quartz Facility/Professional Professional Modifier Low / Median / High Price $437.34 / $911.68 / $1,342.28	Professional		$437.34	$911.68	$1,342.28
Quartz Facility/Professional Facility Modifier Low / Median / High Price $20,731.70 / $20,731.70 / $20,731.70	Facility		$20,731.70	$20,731.70	$20,731.70
Quartz Facility/Professional Professional Modifier Low / Median / High Price $3,825.00 / $4,770.00 / $17,100.00	Professional		$3,825.00	$4,770.00	$17,100.00
Security Health Facility/Professional Professional Modifier Low / Median / High Price $1,959.53 / $1,959.53 / $1,959.53	Professional		$1,959.53	$1,959.53	$1,959.53
Security Health Facility/Professional Professional Modifier Low / Median / High Price $2,334.02 / $6,309.36 / $6,309.36	Professional		$2,334.02	$6,309.36	$6,309.36
United Facility/Professional Professional Modifier Low / Median / High Price $3,750.00 / $3,750.00 / $5,134.50	Professional		$3,750.00	$3,750.00	$5,134.50