Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $922.49 / $922.49 / $17,823.00	Facility		$922.49	$922.49	$17,823.00
Aetna Facility/Professional Professional Modifier Low / Median / High Price $922.49 / $1,674.50 / $2,363.80	Professional		$922.49	$1,674.50	$2,363.80
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $12,080.00 / $18,175.43 / $28,720.00	Facility		$12,080.00	$18,175.43	$28,720.00
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $1,647.96 / $4,297.22 / $11,340.12	Professional		$1,647.96	$4,297.22	$11,340.12
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $922.49 / $1,397.36 / $2,331.63	Facility		$922.49	$1,397.36	$2,331.63
Medica Facility/Professional Facility Modifier Low / Median / High Price $1,397.36 / $3,364.00 / $7,868.00	Facility		$1,397.36	$3,364.00	$7,868.00
Medica Facility/Professional Professional Modifier Low / Median / High Price $2,137.98 / $5,851.58 / $10,017.45	Professional		$2,137.98	$5,851.58	$10,017.45
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 $922.49 / $1,397.36 / $2,331.63	Facility		$922.49	$1,397.36	$2,331.63
Quartz Facility/Professional Professional Modifier Low / Median / High Price $1,977.51 / $3,629.27 / $5,224.89	Professional		$1,977.51	$3,629.27	$5,224.89
Quartz Facility/Professional Facility Modifier Low / Median / High Price $19,593.64 / $19,593.64 / $19,593.64	Facility		$19,593.64	$19,593.64	$19,593.64
Quartz Facility/Professional Professional Modifier Low / Median / High Price $6,296.90 / $11,196.56 / $11,196.56	Professional		$6,296.90	$11,196.56	$11,196.56
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 $1,945.08 / $5,438.45 / $8,457.68	Professional		$1,945.08	$5,438.45	$8,457.68