Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $1,760.00 / $1,760.00 / $1,760.00	Facility		$1,760.00	$1,760.00	$1,760.00
Aetna Facility/Professional Professional Modifier Low / Median / High Price $1,760.00 / $1,760.00 / $1,870.00	Professional		$1,760.00	$1,760.00	$1,870.00
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $2.37 / $5.33 / $1,994.31	Professional		$2.37	$5.33	$1,994.31
Cigna Facility/Professional Facility Modifier Low / Median / High Price $1,870.00 / $1,870.00 / $1,870.00	Facility		$1,870.00	$1,870.00	$1,870.00
Cigna Facility/Professional Professional Modifier Low / Median / High Price $1,870.00 / $1,870.00 / $1,870.00	Professional		$1,870.00	$1,870.00	$1,870.00
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $1,760.00 / $1,782.00 / $2,622.40	Facility		$1,760.00	$1,782.00	$2,622.40
Medica Facility/Professional Facility Modifier Low / Median / High Price $1,760.00 / $1,782.00 / $2,640.00	Facility		$1,760.00	$1,782.00	$2,640.00
Medica Facility/Professional Professional Modifier Low / Median / High Price $2,200.00 / $2,200.00 / $4,620.00	Professional		$2,200.00	$2,200.00	$4,620.00
Molina Facility/Professional Professional Modifier Low / Median / High Price $50.00 / $58.40 / $85.00	Professional		$50.00	$58.40	$85.00
Prevea360 Facility/Professional Facility Modifier Low / Median / High Price $1,760.00 / $1,760.00 / $2,622.40	Facility		$1,760.00	$1,760.00	$2,622.40
Quartz Facility/Professional Professional Modifier Low / Median / High Price $5,900.00 / $5,900.00 / $5,900.00	Professional		$5,900.00	$5,900.00	$5,900.00
Quartz Facility/Professional Facility Modifier Low / Median / High Price $1,870.00 / $2,346.25 / $8,250.00	Facility		$1,870.00	$2,346.25	$8,250.00
Quartz Facility/Professional Professional Modifier Low / Median / High Price $1,870.00 / $2,332.00 / $8,360.00	Professional		$1,870.00	$2,332.00	$8,360.00
United Facility/Professional Professional Modifier Low / Median / High Price $2,200.00 / $2,200.00 / $2,772.00	Professional		$2,200.00	$2,200.00	$2,772.00