Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $787.20 / $787.20 / $14,482.00	Facility		$787.20	$787.20	$14,482.00
Aetna Facility/Professional Professional Modifier Low / Median / High Price $787.20 / $870.85 / $1,395.28	Professional		$787.20	$870.85	$1,395.28
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $11,499.00 / $16,401.00 / $37,855.00	Facility		$11,499.00	$16,401.00	$37,855.00
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $1,280.21 / $2,780.65 / $7,669.48	Professional		$1,280.21	$2,780.65	$7,669.48
Cigna Facility/Professional Professional Modifier Low / Median / High Price $1,753.29 / $5,891.84 / $5,891.84	Professional		$1,753.29	$5,891.84	$5,891.84
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $787.20 / $1,192.41 / $1,968.00	Facility		$787.20	$1,192.41	$1,968.00
Medica Facility/Professional Facility Modifier Low / Median / High Price $813.69 / $1,494.11 / $15,090.00	Facility		$813.69	$1,494.11	$15,090.00
Medica Facility/Professional Professional Modifier Low / Median / High Price $1,462.38 / $2,558.79 / $10,113.68	Professional		$1,462.38	$2,558.79	$10,113.68
Molina Facility/Professional Professional Modifier Low / Median / High Price $50.00 / $55.00 / $70.00	Professional		$50.00	$55.00	$70.00
Prevea360 Facility/Professional Facility Modifier Low / Median / High Price $787.20 / $1,192.41 / $1,968.00	Facility		$787.20	$1,192.41	$1,968.00
Quartz Facility/Professional Professional Modifier Low / Median / High Price $2,493.00 / $3,204.75 / $4,570.50	Professional		$2,493.00	$3,204.75	$4,570.50
Quartz Facility/Professional Facility Modifier Low / Median / High Price $17,698.66 / $17,698.66 / $17,698.66	Facility		$17,698.66	$17,698.66	$17,698.66
Quartz Facility/Professional Professional Modifier Low / Median / High Price $5,688.00 / $5,891.84 / $10,113.68	Professional		$5,688.00	$5,891.84	$10,113.68
United Facility/Professional Facility Modifier Low / Median / High Price $7,984.00 / $13,721.00 / $17,327.00	Facility		$7,984.00	$13,721.00	$17,327.00
United Facility/Professional Professional Modifier Low / Median / High Price $1,454.88 / $2,528.01 / $5,901.63	Professional		$1,454.88	$2,528.01	$5,901.63