Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $190.25 / $190.25 / $14,482.00	Facility		$190.25	$190.25	$14,482.00
Aetna Facility/Professional Professional Modifier Low / Median / High Price $190.25 / $288.18 / $312.35	Professional		$190.25	$288.18	$312.35
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 $292.69 / $585.38 / $1,461.47	Professional		$292.69	$585.38	$1,461.47
Cigna Facility/Professional Professional Modifier Low / Median / High Price $423.47 / $423.47 / $1,053.97	Professional		$423.47	$423.47	$1,053.97
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $190.25 / $357.47 / $476.62	Facility		$190.25	$357.47	$476.62
Medica Facility/Professional Facility Modifier Low / Median / High Price $318.17 / $2,803.00 / $7,868.00	Facility		$318.17	$2,803.00	$7,868.00
Medica Facility/Professional Professional Modifier Low / Median / High Price $338.78 / $631.17 / $2,191.84	Professional		$338.78	$631.17	$2,191.84
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 $190.25 / $357.47 / $476.62	Facility		$190.25	$357.47	$476.62
Quartz Facility/Professional Professional Modifier Low / Median / High Price $433.24 / $769.41 / $1,090.45	Professional		$433.24	$769.41	$1,090.45
Quartz Facility/Professional Facility Modifier Low / Median / High Price $2,341.19 / $2,341.19 / $2,341.19	Facility		$2,341.19	$2,341.19	$2,341.19
Quartz Facility/Professional Professional Modifier Low / Median / High Price $1,379.25 / $2,452.64 / $2,452.64	Professional		$1,379.25	$2,452.64	$2,452.64
United Facility/Professional Facility Modifier Low / Median / High Price $2,203.00 / $4,316.80 / $19,003.00	Facility		$2,203.00	$4,316.80	$19,003.00
United Facility/Professional Professional Modifier Low / Median / High Price $332.79 / $648.96 / $1,366.81	Professional		$332.79	$648.96	$1,366.81