Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $758.58 / $758.58 / $758.58	Facility		$758.58	$758.58	$758.58
Aetna Facility/Professional Professional Modifier Low / Median / High Price $630.96 / $758.58 / $1,122.02	Professional		$630.96	$758.58	$1,122.02
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $1,513.56 / $1,513.56 / $2,511.89	Facility		$1,513.56	$1,513.56	$2,511.89
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $1,288.25 / $1,412.54 / $1,698.24	Professional		$1,288.25	$1,412.54	$1,698.24
Cigna Facility/Professional Facility Modifier Low / Median / High Price $1,047.13 / $3,548.13 / $7,585.78	Facility		$1,047.13	$3,548.13	$7,585.78
Cigna Facility/Professional Professional Modifier Low / Median / High Price $776.25 / $2,187.76 / $2,884.03	Professional		$776.25	$2,187.76	$2,884.03
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $707.95 / $1,230.27 / $1,905.46	Facility		$707.95	$1,230.27	$1,905.46
DeanCare Facility/Professional Professional Modifier Low / Median / High Price $851.14 / $1,513.56 / $1,819.70	Professional		$851.14	$1,513.56	$1,819.70
Medica Facility/Professional Facility Modifier Low / Median / High Price $758.58 / $1,513.56 / $6,760.83	Facility		$758.58	$1,513.56	$6,760.83
Medica Facility/Professional Professional Modifier Low / Median / High Price $630.96 / $758.58 / $1,698.24	Professional		$630.96	$758.58	$1,698.24
Molina Facility/Professional Professional Modifier Low / Median / High Price $54.95 / $70.79 / $676.08	Professional		$54.95	$70.79	$676.08
Quartz Facility/Professional Professional Modifier Low / Median / High Price $1,513.56 / $2,290.87 / $3,981.07	Professional		$1,513.56	$2,290.87	$3,981.07
Quartz Facility/Professional Facility Modifier Low / Median / High Price $1,047.13 / $3,019.95 / $8,128.31	Facility		$1,047.13	$3,019.95	$8,128.31
Quartz Facility/Professional Professional Modifier Low / Median / High Price $776.25 / $1,548.82 / $10,000.00	Professional		$776.25	$1,548.82	$10,000.00
United Facility/Professional Facility Modifier Low / Median / High Price $588.84 / $758.58 / $2,089.30	Facility		$588.84	$758.58	$2,089.30
United Facility/Professional Professional Modifier Low / Median / High Price $501.19 / $741.31 / $1,258.93	Professional		$501.19	$741.31	$1,258.93