Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $1,513.56 / $1,513.56 / $1,513.56	Facility		$1,513.56	$1,513.56	$1,513.56
Aetna Facility/Professional Professional Modifier Low / Median / High Price $1,096.48 / $1,513.56 / $2,398.83	Professional		$1,096.48	$1,513.56	$2,398.83
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $3,090.30 / $3,090.30 / $5,011.87	Facility		$3,090.30	$3,090.30	$5,011.87
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $2,630.27 / $2,818.38 / $3,388.44	Professional		$2,630.27	$2,818.38	$3,388.44
Cigna Facility/Professional Facility Modifier Low / Median / High Price $1,412.54 / $7,079.46 / $15,135.61	Facility		$1,412.54	$7,079.46	$15,135.61
Cigna Facility/Professional Professional Modifier Low / Median / High Price $1,047.13 / $4,365.16 / $5,754.40	Professional		$1,047.13	$4,365.16	$5,754.40
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $1,258.93 / $2,454.71 / $3,801.89	Facility		$1,258.93	$2,454.71	$3,801.89
DeanCare Facility/Professional Professional Modifier Low / Median / High Price $1,737.80 / $3,019.95 / $3,630.78	Professional		$1,737.80	$3,019.95	$3,630.78
Medica Facility/Professional Facility Modifier Low / Median / High Price $1,513.56 / $3,019.95 / $12,022.64	Facility		$1,513.56	$3,019.95	$12,022.64
Medica Facility/Professional Professional Modifier Low / Median / High Price $1,202.26 / $1,698.24 / $3,388.44	Professional		$1,202.26	$1,698.24	$3,388.44
Molina Facility/Professional Professional Modifier Low / Median / High Price $54.95 / $70.79 / $1,513.56	Professional		$54.95	$70.79	$1,513.56
Quartz Facility/Professional Professional Modifier Low / Median / High Price $3,090.30 / $4,570.88 / $7,244.36	Professional		$3,090.30	$4,570.88	$7,244.36
Quartz Facility/Professional Facility Modifier Low / Median / High Price $1,412.54 / $6,025.60 / $14,454.40	Facility		$1,412.54	$6,025.60	$14,454.40
Quartz Facility/Professional Professional Modifier Low / Median / High Price $1,047.13 / $2,089.30 / $14,454.40	Professional		$1,047.13	$2,089.30	$14,454.40
United Facility/Professional Facility Modifier Low / Median / High Price $1,348.96 / $1,698.24 / $3,715.35	Facility		$1,348.96	$1,698.24	$3,715.35
United Facility/Professional Professional Modifier Low / Median / High Price $1,000.00 / $1,513.56 / $2,511.89	Professional		$1,000.00	$1,513.56	$2,511.89