Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $109.90 / $109.90 / $14,482.00	Facility		$109.90	$109.90	$14,482.00
Aetna Facility/Professional Professional Modifier Low / Median / High Price $109.90 / $121.58 / $215.20	Professional		$109.90	$121.58	$215.20
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $5,060.00 / $8,139.00 / $11,136.00	Facility		$5,060.00	$8,139.00	$11,136.00
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $210.48 / $339.49 / $885.58	Professional		$210.48	$339.49	$885.58
Cigna Facility/Professional Facility Modifier Low / Median / High Price $931.76 / $1,088.83 / $1,670.30	Facility		$931.76	$1,088.83	$1,670.30
Cigna Facility/Professional Professional Modifier Low / Median / High Price $392.63 / $554.97 / $630.65	Professional		$392.63	$554.97	$630.65
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $109.90 / $197.82 / $732.17	Facility		$109.90	$197.82	$732.17
Medica Facility/Professional Facility Modifier Low / Median / High Price $128.58 / $442.69 / $11,100.00	Facility		$128.58	$442.69	$11,100.00
Medica Facility/Professional Professional Modifier Low / Median / High Price $302.64 / $480.54 / $1,333.84	Professional		$302.64	$480.54	$1,333.84
Molina Facility/Professional Professional Modifier Low / Median / High Price $50.00 / $58.40 / $737.51	Professional		$50.00	$58.40	$737.51
Prevea360 Facility/Professional Facility Modifier Low / Median / High Price $109.90 / $197.82 / $732.17	Facility		$109.90	$197.82	$732.17
Quartz Facility/Professional Professional Modifier Low / Median / High Price $411.28 / $519.82 / $724.90	Professional		$411.28	$519.82	$724.90
Quartz Facility/Professional Facility Modifier Low / Median / High Price $264.92 / $264.92 / $6,384.05	Facility		$264.92	$264.92	$6,384.05
Quartz Facility/Professional Professional Modifier Low / Median / High Price $750.24 / $1,299.34 / $1,333.84	Professional		$750.24	$1,299.34	$1,333.84
Security Health Facility/Professional Professional Modifier Low / Median / High Price $1,116.34 / $1,116.34 / $1,116.34	Professional		$1,116.34	$1,116.34	$1,116.34
Security Health Facility/Professional Professional Modifier Low / Median / High Price $1,351.82 / $2,250.54 / $2,250.54	Professional		$1,351.82	$2,250.54	$2,250.54
United Facility/Professional Facility Modifier Low / Median / High Price $4,240.00 / $9,158.00 / $12,062.00	Facility		$4,240.00	$9,158.00	$12,062.00
United Facility/Professional Professional Modifier Low / Median / High Price $299.37 / $480.76 / $974.51	Professional		$299.37	$480.76	$974.51