Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $290.14 / $290.14 / $14,482.00	Facility		$290.14	$290.14	$14,482.00
Aetna Facility/Professional Professional Modifier Low / Median / High Price $290.14 / $320.97 / $553.91	Professional		$290.14	$320.97	$553.91
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $11,499.00 / $15,502.00 / $22,165.00	Facility		$11,499.00	$15,502.00	$22,165.00
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $472.07 / $1,057.73 / $2,899.17	Professional		$472.07	$1,057.73	$2,899.17
Cigna Facility/Professional Facility Modifier Low / Median / High Price $10,264.31 / $10,264.31 / $10,264.31	Facility		$10,264.31	$10,264.31	$10,264.31
Cigna Facility/Professional Professional Modifier Low / Median / High Price $646.37 / $2,073.41 / $2,073.41	Professional		$646.37	$2,073.41	$2,073.41
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $290.14 / $439.48 / $727.86	Facility		$290.14	$439.48	$727.86
Medica Facility/Professional Facility Modifier Low / Median / High Price $299.89 / $582.28 / $8,783.00	Facility		$299.89	$582.28	$8,783.00
Medica Facility/Professional Professional Modifier Low / Median / High Price $545.53 / $958.11 / $3,740.24	Professional		$545.53	$958.11	$3,740.24
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 $290.14 / $439.48 / $727.86	Facility		$290.14	$439.48	$727.86
Quartz Facility/Professional Professional Modifier Low / Median / High Price $922.80 / $1,186.26 / $1,691.80	Professional		$922.80	$1,186.26	$1,691.80
Quartz Facility/Professional Facility Modifier Low / Median / High Price $10,264.31 / $10,264.31 / $28,334.00	Facility		$10,264.31	$10,264.31	$28,334.00
Quartz Facility/Professional Professional Modifier Low / Median / High Price $2,103.53 / $2,103.53 / $3,740.24	Professional		$2,103.53	$2,103.53	$3,740.24
United Facility/Professional Facility Modifier Low / Median / High Price $4,614.00 / $7,611.00 / $9,134.00	Facility		$4,614.00	$7,611.00	$9,134.00
United Facility/Professional Professional Modifier Low / Median / High Price $541.38 / $1,000.20 / $2,287.21	Professional		$541.38	$1,000.20	$2,287.21