Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $825.00 / $825.00 / $17,823.00	Facility		$825.00	$825.00	$17,823.00
Aetna Facility/Professional Professional Modifier Low / Median / High Price $825.00 / $825.00 / $4,964.46	Professional		$825.00	$825.00	$4,964.46
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $7,084.00 / $11,783.00 / $18,458.00	Facility		$7,084.00	$11,783.00	$18,458.00
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $1,020.75 / $1,020.75 / $2,158.76	Professional		$1,020.75	$1,020.75	$2,158.76
Cigna Facility/Professional Facility Modifier Low / Median / High Price $2,014.90 / $2,354.58 / $3,797.85	Facility		$2,014.90	$2,354.58	$3,797.85
Cigna Facility/Professional Professional Modifier Low / Median / High Price $1,228.23 / $1,844.70 / $3,854.35	Professional		$1,228.23	$1,844.70	$3,854.35
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $825.00 / $825.00 / $1,785.00	Facility		$825.00	$825.00	$1,785.00
Medica Facility/Professional Facility Modifier Low / Median / High Price $825.00 / $3,583.00 / $7,868.00	Facility		$825.00	$3,583.00	$7,868.00
Medica Facility/Professional Professional Modifier Low / Median / High Price $7,220.45 / $7,220.45 / $7,220.45	Professional		$7,220.45	$7,220.45	$7,220.45
Molina Facility/Professional Professional Modifier Low / Median / High Price $50.00 / $70.00 / $836.80	Professional		$50.00	$70.00	$836.80
Prevea360 Facility/Professional Facility Modifier Low / Median / High Price $825.00 / $825.00 / $1,785.00	Facility		$825.00	$825.00	$1,785.00
Quartz Facility/Professional Professional Modifier Low / Median / High Price $7,220.45 / $7,220.45 / $7,220.45	Professional		$7,220.45	$7,220.45	$7,220.45
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