Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $1,905.46 / $1,905.46 / $1,905.46	Facility		$1,905.46	$1,905.46	$1,905.46
Aetna Facility/Professional Professional Modifier Low / Median / High Price $1,659.59 / $1,905.46 / $3,162.28	Professional		$1,659.59	$1,905.46	$3,162.28
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $3,801.89 / $3,801.89 / $6,309.57	Facility		$3,801.89	$3,801.89	$6,309.57
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $2,630.27 / $3,548.13 / $4,265.80	Professional		$2,630.27	$3,548.13	$4,265.80
Cigna Facility/Professional Facility Modifier Low / Median / High Price $2,290.87 / $8,709.64 / $18,620.87	Facility		$2,290.87	$8,709.64	$18,620.87
Cigna Facility/Professional Professional Modifier Low / Median / High Price $1,659.59 / $5,370.32 / $7,244.36	Professional		$1,659.59	$5,370.32	$7,244.36
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $1,862.09 / $3,090.30 / $4,677.35	Facility		$1,862.09	$3,090.30	$4,677.35
DeanCare Facility/Professional Professional Modifier Low / Median / High Price $3,388.44 / $4,570.88 / $5,754.40	Professional		$3,388.44	$4,570.88	$5,754.40
Medica Facility/Professional Facility Modifier Low / Median / High Price $1,905.46 / $3,715.35 / $17,378.01	Facility		$1,905.46	$3,715.35	$17,378.01
Medica Facility/Professional Professional Modifier Low / Median / High Price $1,659.59 / $2,290.87 / $4,265.80	Professional		$1,659.59	$2,290.87	$4,265.80
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 $3,801.89 / $5,754.40 / $10,471.29	Professional		$3,801.89	$5,754.40	$10,471.29
Quartz Facility/Professional Facility Modifier Low / Median / High Price $2,290.87 / $7,585.78 / $17,378.01	Facility		$2,290.87	$7,585.78	$17,378.01
Quartz Facility/Professional Professional Modifier Low / Median / High Price $1,659.59 / $3,311.31 / $19,054.61	Professional		$1,659.59	$3,311.31	$19,054.61
United Facility/Professional Facility Modifier Low / Median / High Price $1,995.26 / $2,511.89 / $5,495.41	Facility		$1,995.26	$2,511.89	$5,495.41
United Facility/Professional Professional Modifier Low / Median / High Price $1,380.38 / $1,862.09 / $3,162.28	Professional		$1,380.38	$1,862.09	$3,162.28