Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $1,908.26 / $1,908.26 / $1,908.26	Facility		$1,908.26	$1,908.26	$1,908.26
Aetna Facility/Professional Professional Modifier Low / Median / High Price $1,908.26 / $1,908.26 / $2,323.42	Professional		$1,908.26	$1,908.26	$2,323.42
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $3,556.30 / $4,183.89 / $4,183.89	Professional		$3,556.30	$4,183.89	$4,183.89
Cigna Facility/Professional Facility Modifier Low / Median / High Price $4,300.60 / $4,300.60 / $4,300.60	Facility		$4,300.60	$4,300.60	$4,300.60
Cigna Facility/Professional Professional Modifier Low / Median / High Price $4,300.60 / $4,300.60 / $4,300.60	Professional		$4,300.60	$4,300.60	$4,300.60
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $1,908.26 / $1,908.26 / $3,434.87	Facility		$1,908.26	$1,908.26	$3,434.87
Medica Facility/Professional Facility Modifier Low / Median / High Price $80.00 / $1,908.26 / $2,862.39	Facility		$80.00	$1,908.26	$2,862.39
Molina Facility/Professional Professional Modifier Low / Median / High Price $50.00 / $55.00 / $65.00	Professional		$50.00	$55.00	$65.00
Prevea360 Facility/Professional Facility Modifier Low / Median / High Price $1,908.26 / $1,908.26 / $3,434.87	Facility		$1,908.26	$1,908.26	$3,434.87
Quartz Facility/Professional Facility Modifier Low / Median / High Price $65.00 / $65.00 / $4,300.60	Facility		$65.00	$65.00	$4,300.60
Quartz Facility/Professional Professional Modifier Low / Median / High Price $4,300.60 / $4,300.60 / $4,300.60	Professional		$4,300.60	$4,300.60	$4,300.60