Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $138.59 / $138.59 / $14,482.00	Facility		$138.59	$138.59	$14,482.00
Aetna Facility/Professional Professional Modifier Low / Median / High Price $138.59 / $209.92 / $228.23	Professional		$138.59	$209.92	$228.23
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $1,905.00 / $3,496.00 / $5,962.00	Facility		$1,905.00	$3,496.00	$5,962.00
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $225.60 / $426.44 / $1,098.55	Professional		$225.60	$426.44	$1,098.55
Cigna Facility/Professional Professional Modifier Low / Median / High Price $309.10 / $309.10 / $790.79	Professional		$309.10	$309.10	$790.79
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $138.59 / $260.92 / $347.89	Facility		$138.59	$260.92	$347.89
Medica Facility/Professional Facility Modifier Low / Median / High Price $231.62 / $8,225.90 / $15,743.00	Facility		$231.62	$8,225.90	$15,743.00
Medica Facility/Professional Professional Modifier Low / Median / High Price $247.53 / $461.04 / $1,600.83	Professional		$247.53	$461.04	$1,600.83
Molina Facility/Professional Professional Modifier Low / Median / High Price $50.00 / $65.00 / $70.00	Professional		$50.00	$65.00	$70.00
Prevea360 Facility/Professional Facility Modifier Low / Median / High Price $138.59 / $260.92 / $347.89	Facility		$138.59	$260.92	$347.89
Quartz Facility/Professional Professional Modifier Low / Median / High Price $315.89 / $561.03 / $795.12	Professional		$315.89	$561.03	$795.12
Quartz Facility/Professional Facility Modifier Low / Median / High Price $15,056.25 / $15,056.25 / $15,056.25	Facility		$15,056.25	$15,056.25	$15,056.25
Quartz Facility/Professional Professional Modifier Low / Median / High Price $1,006.02 / $1,788.72 / $1,788.72	Professional		$1,006.02	$1,788.72	$1,788.72
United Facility/Professional Facility Modifier Low / Median / High Price $7,301.00 / $11,608.00 / $13,980.00	Facility		$7,301.00	$11,608.00	$13,980.00
United Facility/Professional Professional Modifier Low / Median / High Price $243.10 / $473.99 / $998.29	Professional		$243.10	$473.99	$998.29