Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $643.02 / $643.02 / $17,823.00	Facility		$643.02	$643.02	$17,823.00
Aetna Facility/Professional Professional Modifier Low / Median / High Price $643.02 / $1,052.55 / $1,738.03	Professional		$643.02	$1,052.55	$1,738.03
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 $1,052.08 / $2,609.55 / $7,239.73	Professional		$1,052.08	$2,609.55	$7,239.73
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $643.02 / $1,200.89 / $2,151.59	Facility		$643.02	$1,200.89	$2,151.59
Medica Facility/Professional Facility Modifier Low / Median / High Price $1,280.95 / $12,498.00 / $22,691.00	Facility		$1,280.95	$12,498.00	$22,691.00
Medica Facility/Professional Professional Modifier Low / Median / High Price $1,264.72 / $3,461.61 / $5,925.75	Professional		$1,264.72	$3,461.61	$5,925.75
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 $643.02 / $1,200.89 / $2,151.59	Facility		$643.02	$1,200.89	$2,151.59
Quartz Facility/Professional Professional Modifier Low / Median / High Price $1,454.01 / $2,668.51 / $3,721.30	Professional		$1,454.01	$2,668.51	$3,721.30
Quartz Facility/Professional Facility Modifier Low / Median / High Price $14,402.52 / $14,402.52 / $14,402.52	Facility		$14,402.52	$14,402.52	$14,402.52
Quartz Facility/Professional Professional Modifier Low / Median / High Price $4,628.66 / $8,230.16 / $8,230.16	Professional		$4,628.66	$8,230.16	$8,230.16
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 $1,253.40 / $3,461.61 / $5,393.93	Professional		$1,253.40	$3,461.61	$5,393.93