Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $3,864.00 / $3,864.00 / $3,864.00	Facility		$3,864.00	$3,864.00	$3,864.00
Aetna Facility/Professional Professional Modifier Low / Median / High Price $3,864.00 / $3,864.00 / $4,105.50	Professional		$3,864.00	$3,864.00	$4,105.50
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $2,968.00 / $4,708.47 / $8,651.36	Professional		$2,968.00	$4,708.47	$8,651.36
Cigna Facility/Professional Facility Modifier Low / Median / High Price $3,972.17 / $7,266.63 / $10,299.34	Facility		$3,972.17	$7,266.63	$10,299.34
Cigna Facility/Professional Professional Modifier Low / Median / High Price $3,114.72 / $4,105.50 / $5,260.04	Professional		$3,114.72	$4,105.50	$5,260.04
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $2,968.00 / $3,864.00 / $5,409.60	Facility		$2,968.00	$3,864.00	$5,409.60
Medica Facility/Professional Facility Modifier Low / Median / High Price $2,968.00 / $3,864.00 / $5,757.36	Facility		$2,968.00	$3,864.00	$5,757.36
Medica Facility/Professional Professional Modifier Low / Median / High Price $4,200.00 / $4,200.00 / $8,820.00	Professional		$4,200.00	$4,200.00	$8,820.00
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 $2,968.00 / $3,864.00 / $5,409.60	Facility		$2,968.00	$3,864.00	$5,409.60
Quartz Facility/Professional Professional Modifier Low / Median / High Price $5,994.85 / $6,594.34 / $6,606.16	Professional		$5,994.85	$6,594.34	$6,606.16
Quartz Facility/Professional Facility Modifier Low / Median / High Price $4,105.50 / $4,105.50 / $18,112.50	Facility		$4,105.50	$4,105.50	$18,112.50
Quartz Facility/Professional Professional Modifier Low / Median / High Price $4,105.50 / $5,119.80 / $16,905.00	Professional		$4,105.50	$5,119.80	$16,905.00
Security Health Facility/Professional Professional Modifier Low / Median / High Price $4,167.07 / $4,167.07 / $4,167.07	Professional		$4,167.07	$4,167.07	$4,167.07
United Facility/Professional Professional Modifier Low / Median / High Price $4,200.00 / $4,200.00 / $5,460.00	Professional		$4,200.00	$4,200.00	$5,460.00