Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $167.07 / $167.07 / $14,482.00	Facility		$167.07	$167.07	$14,482.00
Aetna Facility/Professional Professional Modifier Low / Median / High Price $167.07 / $184.81 / $291.38	Professional		$167.07	$184.81	$291.38
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $1,139.00 / $2,479.00 / $4,441.52	Facility		$1,139.00	$2,479.00	$4,441.52
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $256.00 / $524.34 / $1,533.61	Professional		$256.00	$524.34	$1,533.61
Cigna Facility/Professional Facility Modifier Low / Median / High Price $12,237.40 / $12,237.40 / $12,237.40	Facility		$12,237.40	$12,237.40	$12,237.40
Cigna Facility/Professional Professional Modifier Low / Median / High Price $430.09 / $430.09 / $488.74	Professional		$430.09	$430.09	$488.74
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $164.36 / $248.93 / $300.73	Facility		$164.36	$248.93	$300.73
Medica Facility/Professional Facility Modifier Low / Median / High Price $167.07 / $300.36 / $4,793.00	Facility		$167.07	$300.36	$4,793.00
Medica Facility/Professional Professional Modifier Low / Median / High Price $282.32 / $484.78 / $2,270.48	Professional		$282.32	$484.78	$2,270.48
Molina Facility/Professional Professional Modifier Low / Median / High Price $50.00 / $58.40 / $917.41	Professional		$50.00	$58.40	$917.41
Prevea360 Facility/Professional Facility Modifier Low / Median / High Price $164.36 / $248.93 / $300.73	Facility		$164.36	$248.93	$300.73
Quartz Facility/Professional Professional Modifier Low / Median / High Price $592.13 / $920.53 / $1,283.70	Professional		$592.13	$920.53	$1,283.70
Quartz Facility/Professional Facility Modifier Low / Median / High Price $12,237.40 / $12,237.40 / $33,780.60	Facility		$12,237.40	$12,237.40	$33,780.60
Quartz Facility/Professional Professional Modifier Low / Median / High Price $1,596.87 / $1,596.87 / $2,270.48	Professional		$1,596.87	$1,596.87	$2,270.48
United Facility/Professional Facility Modifier Low / Median / High Price $2,367.00 / $3,088.30 / $4,295.00	Facility		$2,367.00	$3,088.30	$4,295.00
United Facility/Professional Professional Modifier Low / Median / High Price $280.06 / $493.36 / $1,098.03	Professional		$280.06	$493.36	$1,098.03