Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $187.51 / $200.00 / $200.00	Facility		$187.51	$200.00	$200.00
Aetna Facility/Professional Professional Modifier Low / Median / High Price $187.51 / $275.51 / $304.95	Professional		$187.51	$275.51	$304.95
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $290.57 / $690.88 / $2,180.96	Professional		$290.57	$690.88	$2,180.96
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $174.08 / $276.77 / $395.29	Facility		$174.08	$276.77	$395.29
Medica Facility/Professional Facility Modifier Low / Median / High Price $187.51 / $282.82 / $2,430.37	Facility		$187.51	$282.82	$2,430.37
Medica Facility/Professional Professional Modifier Low / Median / High Price $364.76 / $811.03 / $1,555.83	Professional		$364.76	$811.03	$1,555.83
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 $174.08 / $276.77 / $395.29	Facility		$174.08	$276.77	$395.29
Quartz Facility/Professional Professional Modifier Low / Median / High Price $484.38 / $691.86 / $986.70	Professional		$484.38	$691.86	$986.70
Quartz Facility/Professional Facility Modifier Low / Median / High Price $1,962.72 / $2,894.15 / $2,894.15	Facility		$1,962.72	$2,894.15	$2,894.15
Quartz Facility/Professional Professional Modifier Low / Median / High Price $1,284.39 / $1,555.83 / $1,555.83	Professional		$1,284.39	$1,555.83	$1,555.83
United Facility/Professional Professional Modifier Low / Median / High Price $350.00 / $739.92 / $1,345.52	Professional		$350.00	$739.92	$1,345.52