Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $3,264.00 / $3,264.00 / $3,264.00	Facility		$3,264.00	$3,264.00	$3,264.00
Aetna Facility/Professional Professional Modifier Low / Median / High Price $3,264.00 / $3,360.00 / $4,080.00	Professional		$3,264.00	$3,360.00	$4,080.00
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $2,356.46 / $2,547.52 / $2,840.48	Facility		$2,356.46	$2,547.52	$2,840.48
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $3,400.00 / $3,400.00 / $3,468.00	Professional		$3,400.00	$3,400.00	$3,468.00
Cigna Facility/Professional Facility Modifier Low / Median / High Price $703.65 / $1,287.25 / $3,468.00	Facility		$703.65	$1,287.25	$3,468.00
Cigna Facility/Professional Professional Modifier Low / Median / High Price $3,468.00 / $3,468.00 / $4,080.00	Professional		$3,468.00	$3,468.00	$4,080.00
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $3,264.00 / $3,264.00 / $4,080.00	Facility		$3,264.00	$3,264.00	$4,080.00
Medica Facility/Professional Facility Modifier Low / Median / High Price $3,264.00 / $3,386.40 / $15,300.00	Facility		$3,264.00	$3,386.40	$15,300.00
Medica Facility/Professional Professional Modifier Low / Median / High Price $3,400.00 / $3,400.00 / $15,504.00	Professional		$3,400.00	$3,400.00	$15,504.00
Molina Facility/Professional Professional Modifier Low / Median / High Price $50.00 / $65.00 / $10,570.56	Professional		$50.00	$65.00	$10,570.56
Prevea360 Facility/Professional Facility Modifier Low / Median / High Price $3,264.00 / $3,304.80 / $4,080.00	Facility		$3,264.00	$3,304.80	$4,080.00
Quartz Facility/Professional Facility Modifier Low / Median / High Price $5,095.04 / $15,300.00 / $15,300.00	Facility		$5,095.04	$15,300.00	$15,300.00
Quartz Facility/Professional Professional Modifier Low / Median / High Price $3,468.00 / $4,324.80 / $15,504.00	Professional		$3,468.00	$4,324.80	$15,504.00
United Facility/Professional Professional Modifier Low / Median / High Price $3,400.00 / $3,400.00 / $4,420.00	Professional		$3,400.00	$3,400.00	$4,420.00