Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $1,737.80 / $1,737.80 / $1,737.80	Facility		$1,737.80	$1,737.80	$1,737.80
Aetna Facility/Professional Professional Modifier Low / Median / High Price $1,288.25 / $1,737.80 / $2,089.30	Professional		$1,288.25	$1,737.80	$2,089.30
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $2,630.27 / $4,786.30 / $4,786.30	Facility		$2,630.27	$4,786.30	$4,786.30
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $1,995.26 / $2,630.27 / $3,311.31	Professional		$1,995.26	$2,630.27	$3,311.31
Cigna Facility/Professional Facility Modifier Low / Median / High Price $1,621.81 / $1,621.81 / $12,882.50	Facility		$1,621.81	$1,621.81	$12,882.50
Cigna Facility/Professional Professional Modifier Low / Median / High Price $1,621.81 / $3,630.78 / $5,128.61	Professional		$1,621.81	$3,630.78	$5,128.61
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $257.04 / $1,288.25 / $2,511.89	Facility		$257.04	$1,288.25	$2,511.89
DeanCare Facility/Professional Professional Modifier Low / Median / High Price $1,288.25 / $1,288.25 / $1,288.25	Professional		$1,288.25	$1,288.25	$1,288.25
Medica Facility/Professional Facility Modifier Low / Median / High Price $295.12 / $1,819.70 / $12,022.64	Facility		$295.12	$1,819.70	$12,022.64
Medica Facility/Professional Professional Modifier Low / Median / High Price $933.25 / $1,258.93 / $1,995.26	Professional		$933.25	$1,258.93	$1,995.26
Molina Facility/Professional Professional Modifier Low / Median / High Price $1.86 / $151.36 / $1,202.26	Professional		$1.86	$151.36	$1,202.26
Quartz Facility/Professional Professional Modifier Low / Median / High Price $302.00 / $524.81 / $676.08	Professional		$302.00	$524.81	$676.08
Quartz Facility/Professional Facility Modifier Low / Median / High Price $1,621.81 / $4,265.80 / $12,302.69	Facility		$1,621.81	$4,265.80	$12,302.69
Quartz Facility/Professional Professional Modifier Low / Median / High Price $190.55 / $1,621.81 / $1,621.81	Professional		$190.55	$1,621.81	$1,621.81
United Facility/Professional Facility Modifier Low / Median / High Price $107.15 / $954.99 / $1,778.28	Facility		$107.15	$954.99	$1,778.28
United Facility/Professional Professional Modifier Low / Median / High Price $891.25 / $1,258.93 / $2,187.76	Professional		$891.25	$1,258.93	$2,187.76