Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $656.25 / $656.25 / $14,482.00	Facility		$656.25	$656.25	$14,482.00
Aetna Facility/Professional Professional Modifier Low / Median / High Price $656.25 / $656.25 / $1,377.86	Professional		$656.25	$656.25	$1,377.86
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $5,060.00 / $7,344.00 / $10,517.23	Facility		$5,060.00	$7,344.00	$10,517.23
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $168.10 / $210.12 / $304.22	Professional		$168.10	$210.12	$304.22
Cigna Facility/Professional Facility Modifier Low / Median / High Price $1,480.54 / $1,730.13 / $2,654.06	Facility		$1,480.54	$1,730.13	$2,654.06
Cigna Facility/Professional Professional Modifier Low / Median / High Price $902.50 / $1,182.74 / $3,844.78	Professional		$902.50	$1,182.74	$3,844.78
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $656.25 / $656.25 / $2,068.84	Facility		$656.25	$656.25	$2,068.84
Medica Facility/Professional Facility Modifier Low / Median / High Price $656.25 / $7,251.10 / $12,631.00	Facility		$656.25	$7,251.10	$12,631.00
Medica Facility/Professional Professional Modifier Low / Median / High Price $3,840.00 / $3,840.00 / $3,840.00	Professional		$3,840.00	$3,840.00	$3,840.00
Molina Facility/Professional Professional Modifier Low / Median / High Price $50.00 / $65.00 / $85.00	Professional		$50.00	$65.00	$85.00
Prevea360 Facility/Professional Facility Modifier Low / Median / High Price $656.25 / $656.25 / $2,068.84	Facility		$656.25	$656.25	$2,068.84
Quartz Facility/Professional Professional Modifier Low / Median / High Price $3,840.00 / $3,840.00 / $3,840.00	Professional		$3,840.00	$3,840.00	$3,840.00
Security Health Facility/Professional Professional Modifier Low / Median / High Price $1,181.08 / $1,181.08 / $1,181.08	Professional		$1,181.08	$1,181.08	$1,181.08
United Facility/Professional Facility Modifier Low / Median / High Price $6,241.00 / $9,837.00 / $12,062.00	Facility		$6,241.00	$9,837.00	$12,062.00