Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $5,057.00 / $7,774.00 / $12,204.00	Facility		$5,057.00	$7,774.00	$12,204.00
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $102.10 / $251.80 / $721.47	Professional		$102.10	$251.80	$721.47
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $56.74 / $113.30 / $330.56	Facility		$56.74	$113.30	$330.56
Medica Facility/Professional Facility Modifier Low / Median / High Price $196.80 / $7,600.80 / $12,631.00	Facility		$196.80	$7,600.80	$12,631.00
Medica Facility/Professional Professional Modifier Low / Median / High Price $135.00 / $346.59 / $579.66	Professional		$135.00	$346.59	$579.66
Molina Facility/Professional Professional Modifier Low / Median / High Price $50.00 / $50.00 / $70.00	Professional		$50.00	$50.00	$70.00
Prevea360 Facility/Professional Facility Modifier Low / Median / High Price $56.74 / $113.30 / $330.56	Facility		$56.74	$113.30	$330.56
Quartz Facility/Professional Professional Modifier Low / Median / High Price $235.68 / $611.32 / $852.50	Professional		$235.68	$611.32	$852.50
Quartz Facility/Professional Facility Modifier Low / Median / High Price $11,028.25 / $11,028.25 / $11,028.25	Facility		$11,028.25	$11,028.25	$11,028.25
Quartz Facility/Professional Professional Modifier Low / Median / High Price $1,060.83 / $1,397.00 / $1,397.00	Professional		$1,060.83	$1,397.00	$1,397.00
United Facility/Professional Facility Modifier Low / Median / High Price $3,163.00 / $3,163.00 / $3,163.00	Facility		$3,163.00	$3,163.00	$3,163.00
United Facility/Professional Professional Modifier Low / Median / High Price $145.00 / $338.03 / $506.16	Professional		$145.00	$338.03	$506.16