Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $194.04 / $194.04 / $17,823.00	Facility		$194.04	$194.04	$17,823.00
Aetna Facility/Professional Professional Modifier Low / Median / High Price $194.04 / $308.79 / $497.34	Professional		$194.04	$308.79	$497.34
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $5,060.00 / $7,344.00 / $10,517.23	Facility		$5,060.00	$7,344.00	$10,517.23
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $315.70 / $839.04 / $1,921.78	Professional		$315.70	$839.04	$1,921.78
Cigna Facility/Professional Professional Modifier Low / Median / High Price $432.41 / $432.41 / $1,066.26	Professional		$432.41	$432.41	$1,066.26
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $194.04 / $293.94 / $615.70	Facility		$194.04	$293.94	$615.70
Medica Facility/Professional Facility Modifier Low / Median / High Price $293.94 / $2,803.00 / $7,868.00	Facility		$293.94	$2,803.00	$7,868.00
Medica Facility/Professional Professional Modifier Low / Median / High Price $367.56 / $1,045.40 / $1,856.41	Professional		$367.56	$1,045.40	$1,856.41
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 $194.04 / $293.94 / $615.70	Facility		$194.04	$293.94	$615.70
Quartz Facility/Professional Professional Modifier Low / Median / High Price $416.05 / $763.56 / $1,099.26	Professional		$416.05	$763.56	$1,099.26
Quartz Facility/Professional Facility Modifier Low / Median / High Price $1,465.35 / $1,465.35 / $1,465.35	Facility		$1,465.35	$1,465.35	$1,465.35
Quartz Facility/Professional Professional Modifier Low / Median / High Price $1,325.93 / $2,357.76 / $2,357.76	Professional		$1,325.93	$2,357.76	$2,357.76
United Facility/Professional Facility Modifier Low / Median / High Price $2,203.00 / $4,316.80 / $19,003.00	Facility		$2,203.00	$4,316.80	$19,003.00
United Facility/Professional Professional Modifier Low / Median / High Price $363.98 / $1,045.40 / $1,454.07	Professional		$363.98	$1,045.40	$1,454.07