Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $1,659.59 / $1,659.59 / $1,659.59	Facility		$1,659.59	$1,659.59	$1,659.59
Aetna Facility/Professional Professional Modifier Low / Median / High Price $1,380.38 / $1,659.59 / $2,754.23	Professional		$1,380.38	$1,659.59	$2,754.23
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $3,388.44 / $3,388.44 / $5,495.41	Facility		$3,388.44	$3,388.44	$5,495.41
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $2,511.89 / $3,090.30 / $3,715.35	Professional		$2,511.89	$3,090.30	$3,715.35
Cigna Facility/Professional Facility Modifier Low / Median / High Price $1,737.80 / $7,762.47 / $16,595.87	Facility		$1,737.80	$7,762.47	$16,595.87
Cigna Facility/Professional Professional Modifier Low / Median / High Price $1,258.93 / $4,786.30 / $6,309.57	Professional		$1,258.93	$4,786.30	$6,309.57
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $1,548.82 / $2,691.53 / $4,168.69	Facility		$1,548.82	$2,691.53	$4,168.69
DeanCare Facility/Professional Professional Modifier Low / Median / High Price $3,019.95 / $4,265.80 / $5,370.32	Professional		$3,019.95	$4,265.80	$5,370.32
Medica Facility/Professional Facility Modifier Low / Median / High Price $1,659.59 / $3,311.31 / $14,791.08	Facility		$1,659.59	$3,311.31	$14,791.08
Medica Facility/Professional Professional Modifier Low / Median / High Price $1,380.38 / $1,995.26 / $3,715.35	Professional		$1,380.38	$1,995.26	$3,715.35
Molina Facility/Professional Professional Modifier Low / Median / High Price $54.95 / $70.79 / $1,995.26	Professional		$54.95	$70.79	$1,995.26
Quartz Facility/Professional Professional Modifier Low / Median / High Price $3,388.44 / $5,011.87 / $8,709.64	Professional		$3,388.44	$5,011.87	$8,709.64
Quartz Facility/Professional Facility Modifier Low / Median / High Price $1,737.80 / $6,760.83 / $15,488.17	Facility		$1,737.80	$6,760.83	$15,488.17
Quartz Facility/Professional Professional Modifier Low / Median / High Price $1,258.93 / $2,570.40 / $16,982.44	Professional		$1,258.93	$2,570.40	$16,982.44
United Facility/Professional Facility Modifier Low / Median / High Price $1,445.44 / $2,089.30 / $4,570.88	Facility		$1,445.44	$2,089.30	$4,570.88
United Facility/Professional Professional Modifier Low / Median / High Price $1,148.15 / $1,659.59 / $2,754.23	Professional		$1,148.15	$1,659.59	$2,754.23