Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $167.78 / $167.78 / $17,823.00	Facility		$167.78	$167.78	$17,823.00
Aetna Facility/Professional Professional Modifier Low / Median / High Price $167.78 / $304.64 / $564.04	Professional		$167.78	$304.64	$564.04
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $13,123.00 / $18,187.00 / $24,019.00	Facility		$13,123.00	$18,187.00	$24,019.00
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $198.69 / $619.49 / $2,848.22	Professional		$198.69	$619.49	$2,848.22
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $167.78 / $296.77 / $565.72	Facility		$167.78	$296.77	$565.72
Medica Facility/Professional Facility Modifier Low / Median / High Price $208.71 / $506.91 / $6,283.00	Facility		$208.71	$506.91	$6,283.00
Medica Facility/Professional Professional Modifier Low / Median / High Price $540.34 / $1,050.00 / $2,216.63	Professional		$540.34	$1,050.00	$2,216.63
Molina Facility/Professional Professional Modifier Low / Median / High Price $50.00 / $58.40 / $70.00	Professional		$50.00	$58.40	$70.00
Prevea360 Facility/Professional Facility Modifier Low / Median / High Price $167.78 / $296.77 / $565.72	Facility		$167.78	$296.77	$565.72
Quartz Facility/Professional Professional Modifier Low / Median / High Price $359.31 / $662.11 / $1,124.16	Professional		$359.31	$662.11	$1,124.16
Quartz Facility/Professional Facility Modifier Low / Median / High Price $2,589.44 / $2,589.44 / $2,589.44	Facility		$2,589.44	$2,589.44	$2,589.44
Quartz Facility/Professional Professional Modifier Low / Median / High Price $1,144.44 / $2,197.25 / $2,197.25	Professional		$1,144.44	$2,197.25	$2,197.25
United Facility/Professional Facility Modifier Low / Median / High Price $2,429.00 / $4,917.00 / $19,003.00	Facility		$2,429.00	$4,917.00	$19,003.00
United Facility/Professional Professional Modifier Low / Median / High Price $497.10 / $972.42 / $2,216.63	Professional		$497.10	$972.42	$2,216.63