Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $1,570.40 / $2,093.86 / $2,093.86	Facility		$1,570.40	$2,093.86	$2,093.86
Aetna Facility/Professional Professional Modifier Low / Median / High Price $1,690.03 / $2,742.96 / $2,742.96	Professional		$1,690.03	$2,742.96	$2,742.96
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $1,936.82 / $2,250.90 / $2,334.65	Facility		$1,936.82	$2,250.90	$2,334.65
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $1,007.42 / $1,007.42 / $1,486.64	Professional		$1,007.42	$1,007.42	$1,486.64
Cigna Facility/Professional Facility Modifier Low / Median / High Price $1,046.93 / $2,541.11 / $3,632.36	Facility		$1,046.93	$2,541.11	$3,632.36
Cigna Facility/Professional Professional Modifier Low / Median / High Price $1,066.50 / $1,698.73 / $1,930.38	Professional		$1,066.50	$1,698.73	$1,930.38
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $962.13 / $1,046.93 / $1,046.93	Facility		$962.13	$1,046.93	$1,046.93
DeanCare Facility/Professional Professional Modifier Low / Median / High Price $1,570.40 / $1,570.40 / $1,570.40	Professional		$1,570.40	$1,570.40	$1,570.40
Medica Facility/Professional Facility Modifier Low / Median / High Price $962.13 / $1,046.93 / $1,046.93	Facility		$962.13	$1,046.93	$1,046.93
Medica Facility/Professional Professional Modifier Low / Median / High Price $1,185.20 / $1,185.20 / $1,570.40	Professional		$1,185.20	$1,185.20	$1,570.40
Molina Facility/Professional Professional Modifier Low / Median / High Price $65.00 / $85.00 / $3,464.58	Professional		$65.00	$85.00	$3,464.58
Prevea360 Facility/Professional Facility Modifier Low / Median / High Price $962.13 / $1,046.93 / $1,046.93	Facility		$962.13	$1,046.93	$1,046.93
Prevea360 Facility/Professional Professional Modifier Low / Median / High Price $1,570.40 / $1,570.40 / $1,570.40	Professional		$1,570.40	$1,570.40	$1,570.40
Quartz Facility/Professional Professional Modifier Low / Median / High Price $1,849.91 / $1,849.91 / $1,849.91	Professional		$1,849.91	$1,849.91	$1,849.91
Quartz Facility/Professional Facility Modifier Low / Median / High Price $5,234.64 / $5,234.64 / $5,234.64	Facility		$5,234.64	$5,234.64	$5,234.64
Quartz Facility/Professional Professional Modifier Low / Median / High Price $1,046.93 / $1,046.93 / $1,046.93	Professional		$1,046.93	$1,046.93	$1,046.93
Security Health Facility/Professional Professional Modifier Low / Median / High Price $1,308.66 / $1,469.89 / $1,655.85	Professional		$1,308.66	$1,469.89	$1,655.85
United Facility/Professional Professional Modifier Low / Median / High Price $1,185.20 / $1,185.20 / $1,622.78	Professional		$1,185.20	$1,185.20	$1,622.78