Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $5,036.26 / $5,036.26 / $11,230.90	Facility		$5,036.26	$5,036.26	$11,230.90
Aetna Facility/Professional Professional Modifier Low / Median / High Price $5,036.26 / $5,036.26 / $6,295.32	Professional		$5,036.26	$5,036.26	$6,295.32
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $9,013.09 / $10,474.67 / $10,864.43	Facility		$9,013.09	$10,474.67	$10,864.43
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $5,246.10 / $5,246.10 / $5,351.02	Professional		$5,246.10	$5,246.10	$5,351.02
Cigna Facility/Professional Facility Modifier Low / Median / High Price $4,884.92 / $8,860.84 / $12,665.99	Facility		$4,884.92	$8,860.84	$12,665.99
Cigna Facility/Professional Professional Modifier Low / Median / High Price $3,718.88 / $3,830.44 / $5,351.02	Professional		$3,718.88	$3,830.44	$5,351.02
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $5,036.26 / $6,295.32 / $6,295.32	Facility		$5,036.26	$6,295.32	$6,295.32
Medica Facility/Professional Facility Modifier Low / Median / High Price $4,859.01 / $5,036.26 / $6,295.32	Facility		$4,859.01	$5,036.26	$6,295.32
Medica Facility/Professional Professional Modifier Low / Median / High Price $5,246.10 / $5,246.10 / $6,819.93	Professional		$5,246.10	$5,246.10	$6,819.93
Molina Facility/Professional Professional Modifier Low / Median / High Price $50.00 / $65.00 / $18,840.24	Professional		$50.00	$65.00	$18,840.24
Prevea360 Facility/Professional Facility Modifier Low / Median / High Price $5,036.26 / $6,295.32 / $6,295.32	Facility		$5,036.26	$6,295.32	$6,295.32
Quartz Facility/Professional Facility Modifier Low / Median / High Price $25,317.80 / $25,317.80 / $25,317.80	Facility		$25,317.80	$25,317.80	$25,317.80
Quartz Facility/Professional Professional Modifier Low / Median / High Price $5,351.02 / $5,351.02 / $5,351.02	Professional		$5,351.02	$5,351.02	$5,351.02
Security Health Facility/Professional Professional Modifier Low / Median / High Price $4,141.13 / $4,141.13 / $7,571.48	Professional		$4,141.13	$4,141.13	$7,571.48
United Facility/Professional Facility Modifier Low / Median / High Price $4,855.30 / $4,855.30 / $11,361.40	Facility		$4,855.30	$4,855.30	$11,361.40
United Facility/Professional Professional Modifier Low / Median / High Price $5,246.10 / $5,246.10 / $6,819.93	Professional		$5,246.10	$5,246.10	$6,819.93