Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $259.87 / $259.87 / $17,823.00	Facility		$259.87	$259.87	$17,823.00
Aetna Facility/Professional Professional Modifier Low / Median / High Price $259.87 / $425.34 / $679.83	Professional		$259.87	$425.34	$679.83
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $12,080.00 / $17,505.00 / $23,937.00	Facility		$12,080.00	$17,505.00	$23,937.00
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $557.19 / $985.31 / $3,903.59	Professional		$557.19	$985.31	$3,903.59
Cigna Facility/Professional Professional Modifier Low / Median / High Price $793.35 / $793.35 / $793.35	Professional		$793.35	$793.35	$793.35
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $259.87 / $459.60 / $823.45	Facility		$259.87	$459.60	$823.45
Medica Facility/Professional Facility Modifier Low / Median / High Price $490.24 / $12,498.00 / $22,691.00	Facility		$490.24	$12,498.00	$22,691.00
Medica Facility/Professional Professional Modifier Low / Median / High Price $702.20 / $1,773.07 / $2,946.67	Professional		$702.20	$1,773.07	$2,946.67
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 $259.87 / $459.60 / $823.45	Facility		$259.87	$459.60	$823.45
Quartz Facility/Professional Professional Modifier Low / Median / High Price $557.02 / $1,215.67 / $1,471.74	Professional		$557.02	$1,215.67	$1,471.74
Quartz Facility/Professional Facility Modifier Low / Median / High Price $81,086.85 / $81,086.85 / $81,086.85	Facility		$81,086.85	$81,086.85	$81,086.85
Quartz Facility/Professional Professional Modifier Low / Median / High Price $1,773.41 / $2,946.67 / $2,946.67	Professional		$1,773.41	$2,946.67	$2,946.67
United Facility/Professional Facility Modifier Low / Median / High Price $8,650.00 / $14,566.00 / $19,562.00	Facility		$8,650.00	$14,566.00	$19,562.00
United Facility/Professional Professional Modifier Low / Median / High Price $588.03 / $1,919.00 / $2,776.55	Professional		$588.03	$1,919.00	$2,776.55