Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $912.01 / $912.01 / $912.01	Facility		$912.01	$912.01	$912.01
Aetna Facility/Professional Professional Modifier Low / Median / High Price $758.58 / $912.01 / $1,513.56	Professional		$758.58	$912.01	$1,513.56
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $1,819.70 / $1,819.70 / $3,019.95	Facility		$1,819.70	$1,819.70	$3,019.95
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $1,380.38 / $1,698.24 / $2,041.74	Professional		$1,380.38	$1,698.24	$2,041.74
Cigna Facility/Professional Facility Modifier Low / Median / High Price $1,258.93 / $4,168.69 / $8,912.51	Facility		$1,258.93	$4,168.69	$8,912.51
Cigna Facility/Professional Professional Modifier Low / Median / High Price $912.01 / $2,570.40 / $3,467.37	Professional		$912.01	$2,570.40	$3,467.37
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $851.14 / $1,479.11 / $2,238.72	Facility		$851.14	$1,479.11	$2,238.72
DeanCare Facility/Professional Professional Modifier Low / Median / High Price $1,023.29 / $1,778.28 / $2,187.76	Professional		$1,023.29	$1,778.28	$2,187.76
Medica Facility/Professional Facility Modifier Low / Median / High Price $912.01 / $1,778.28 / $8,128.31	Facility		$912.01	$1,778.28	$8,128.31
Medica Facility/Professional Professional Modifier Low / Median / High Price $776.25 / $1,096.48 / $2,041.74	Professional		$776.25	$1,096.48	$2,041.74
Molina Facility/Professional Professional Modifier Low / Median / High Price $54.95 / $70.79 / $1,000.00	Professional		$54.95	$70.79	$1,000.00
Quartz Facility/Professional Professional Modifier Low / Median / High Price $1,819.70 / $2,754.23 / $4,897.79	Professional		$1,819.70	$2,754.23	$4,897.79
Quartz Facility/Professional Facility Modifier Low / Median / High Price $1,258.93 / $3,630.78 / $9,332.54	Facility		$1,258.93	$3,630.78	$9,332.54
Quartz Facility/Professional Professional Modifier Low / Median / High Price $912.01 / $1,949.84 / $9,549.93	Professional		$912.01	$1,949.84	$9,549.93
United Facility/Professional Facility Modifier Low / Median / High Price $912.01 / $1,148.15 / $2,511.89	Facility		$912.01	$1,148.15	$2,511.89
United Facility/Professional Professional Modifier Low / Median / High Price $645.65 / $891.25 / $1,513.56	Professional		$645.65	$891.25	$1,513.56