Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $1,188.00 / $1,188.00 / $1,188.00	Facility		$1,188.00	$1,188.00	$1,188.00
Aetna Facility/Professional Professional Modifier Low / Median / High Price $1,188.00 / $1,188.00 / $1,485.00	Professional		$1,188.00	$1,188.00	$1,485.00
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $2,426.73 / $2,820.26 / $2,925.20	Facility		$2,426.73	$2,820.26	$2,925.20
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $1,239.98 / $1,262.25 / $1,410.75	Professional		$1,239.98	$1,262.25	$1,410.75
Cigna Facility/Professional Facility Modifier Low / Median / High Price $1,755.56 / $3,211.59 / $4,551.93	Facility		$1,755.56	$3,211.59	$4,551.93
Cigna Facility/Professional Professional Modifier Low / Median / High Price $1,336.50 / $1,965.39 / $2,233.40	Professional		$1,336.50	$1,965.39	$2,233.40
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $1,167.15 / $1,311.75 / $1,485.00	Facility		$1,167.15	$1,311.75	$1,485.00
DeanCare Facility/Professional Professional Modifier Low / Median / High Price $28.59 / $28.59 / $1,967.63	Professional		$28.59	$28.59	$1,967.63
Medica Facility/Professional Facility Modifier Low / Median / High Price $6,558.75 / $6,558.75 / $6,558.75	Facility		$6,558.75	$6,558.75	$6,558.75
Molina Facility/Professional Professional Modifier Low / Median / High Price $85.00 / $85.00 / $85.00	Professional		$85.00	$85.00	$85.00
Prevea360 Facility/Professional Facility Modifier Low / Median / High Price $1,167.15 / $1,311.75 / $1,485.00	Facility		$1,167.15	$1,311.75	$1,485.00
Prevea360 Facility/Professional Professional Modifier Low / Median / High Price $28.59 / $28.59 / $1,967.63	Professional		$28.59	$28.59	$1,967.63
Quartz Facility/Professional Professional Modifier Low / Median / High Price $2,221.56 / $2,221.56 / $2,221.56	Professional		$2,221.56	$2,221.56	$2,221.56
Quartz Facility/Professional Facility Modifier Low / Median / High Price $5,247.00 / $5,247.00 / $6,558.75	Facility		$5,247.00	$5,247.00	$6,558.75
Quartz Facility/Professional Professional Modifier Low / Median / High Price $1,262.25 / $1,262.25 / $1,262.25	Professional		$1,262.25	$1,262.25	$1,262.25
Security Health Facility/Professional Professional Modifier Low / Median / High Price $1,428.64 / $1,841.70 / $1,841.70	Professional		$1,428.64	$1,841.70	$1,841.70