Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $2,900.19 / $2,900.19 / $6,467.42	Facility		$2,900.19	$2,900.19	$6,467.42
Aetna Facility/Professional Professional Modifier Low / Median / High Price $2,900.19 / $2,900.19 / $3,625.24	Professional		$2,900.19	$2,900.19	$3,625.24
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $4,258.53 / $4,949.10 / $5,133.26	Facility		$4,258.53	$4,949.10	$5,133.26
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $1,153.95 / $3,021.04 / $3,627.10	Professional		$1,153.95	$3,021.04	$3,627.10
Cigna Facility/Professional Facility Modifier Low / Median / High Price $3,081.45 / $5,639.77 / $8,061.69	Facility		$3,081.45	$5,639.77	$8,061.69
Cigna Facility/Professional Professional Modifier Low / Median / High Price $1,888.89 / $2,146.46 / $2,958.75	Professional		$1,888.89	$2,146.46	$2,958.75
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $1,125.75 / $2,301.91 / $2,900.19	Facility		$1,125.75	$2,301.91	$2,900.19
DeanCare Facility/Professional Professional Modifier Low / Median / High Price $599.64 / $599.64 / $3,452.87	Professional		$599.64	$599.64	$3,452.87
Medica Facility/Professional Facility Modifier Low / Median / High Price $1,125.75 / $2,301.91 / $2,904.57	Facility		$1,125.75	$2,301.91	$2,904.57
Medica Facility/Professional Professional Modifier Low / Median / High Price $3,021.04 / $3,021.04 / $3,927.35	Professional		$3,021.04	$3,021.04	$3,927.35
Molina Facility/Professional Professional Modifier Low / Median / High Price $65.00 / $85.00 / $7,618.03	Professional		$65.00	$85.00	$7,618.03
Prevea360 Facility/Professional Facility Modifier Low / Median / High Price $1,125.75 / $2,301.91 / $2,900.19	Facility		$1,125.75	$2,301.91	$2,900.19
Prevea360 Facility/Professional Professional Modifier Low / Median / High Price $599.64 / $599.64 / $3,452.87	Professional		$599.64	$599.64	$3,452.87
Quartz Facility/Professional Professional Modifier Low / Median / High Price $1,222.61 / $2,592.42 / $3,738.90	Professional		$1,222.61	$2,592.42	$3,738.90
Quartz Facility/Professional Facility Modifier Low / Median / High Price $13,885.70 / $13,885.70 / $13,885.70	Facility		$13,885.70	$13,885.70	$13,885.70
Quartz Facility/Professional Professional Modifier Low / Median / High Price $3,081.45 / $3,081.45 / $3,081.45	Professional		$3,081.45	$3,081.45	$3,081.45
Security Health Facility/Professional Professional Modifier Low / Median / High Price $2,055.82 / $2,055.82 / $3,758.77	Professional		$2,055.82	$2,055.82	$3,758.77
United Facility/Professional Professional Modifier Low / Median / High Price $3,021.04 / $3,021.04 / $4,229.46	Professional		$3,021.04	$3,021.04	$4,229.46