Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $84.67 / $262.79 / $1,894.00	Facility		$84.67	$262.79	$1,894.00
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $1,139.00 / $2,479.00 / $4,441.52	Facility		$1,139.00	$2,479.00	$4,441.52
CareSource Facility/Professional Facility Modifier Low / Median / High Price $822.21 / $822.21 / $822.21	Facility		$822.21	$822.21	$822.21
Cigna Facility/Professional Facility Modifier Low / Median / High Price $718.19 / $839.26 / $1,287.45	Facility		$718.19	$839.26	$1,287.45
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $84.67 / $187.12 / $535.09	Facility		$84.67	$187.12	$535.09
Medica Facility/Professional Facility Modifier Low / Median / High Price $84.67 / $261.33 / $2,951.70	Facility		$84.67	$261.33	$2,951.70
Prevea360 Facility/Professional Facility Modifier Low / Median / High Price $84.67 / $187.12 / $535.09	Facility		$84.67	$187.12	$535.09
Quartz Facility/Professional Professional Modifier Low / Median / High Price $205.17 / $364.72 / $865.63	Professional		$205.17	$364.72	$865.63
Quartz Facility/Professional Facility Modifier Low / Median / High Price $432.28 / $432.28 / $775.87	Facility		$432.28	$432.28	$775.87
United Facility/Professional Facility Modifier Low / Median / High Price $1,957.00 / $3,068.00 / $4,295.00	Facility		$1,957.00	$3,068.00	$4,295.00