Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $122.61 / $410.66 / $14,482.00	Facility		$122.61	$410.66	$14,482.00
Aetna Facility/Professional Professional Modifier Low / Median / High Price $108.19 / $122.61 / $328.53	Professional		$108.19	$122.61	$328.53
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $5,479.00 / $8,746.00 / $15,579.70	Facility		$5,479.00	$8,746.00	$15,579.70
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $109.63 / $251.52 / $646.28	Professional		$109.63	$251.52	$646.28
Cigna Facility/Professional Facility Modifier Low / Median / High Price $287.45 / $335.92 / $515.29	Facility		$287.45	$335.92	$515.29
Cigna Facility/Professional Professional Modifier Low / Median / High Price $142.21 / $386.28 / $458.39	Professional		$142.21	$386.28	$458.39
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $110.18 / $142.52 / $244.64	Facility		$110.18	$142.52	$244.64
Medica Facility/Professional Facility Modifier Low / Median / High Price $110.18 / $166.08 / $10,843.00	Facility		$110.18	$166.08	$10,843.00
Medica Facility/Professional Professional Modifier Low / Median / High Price $122.34 / $259.42 / $842.96	Professional		$122.34	$259.42	$842.96
Molina Facility/Professional Professional Modifier Low / Median / High Price $70.00 / $198.60 / $343.37	Professional		$70.00	$198.60	$343.37
Prevea360 Facility/Professional Facility Modifier Low / Median / High Price $110.18 / $141.00 / $244.64	Facility		$110.18	$141.00	$244.64
Quartz Facility/Professional Professional Modifier Low / Median / High Price $213.00 / $284.07 / $463.73	Professional		$213.00	$284.07	$463.73
Quartz Facility/Professional Facility Modifier Low / Median / High Price $132.63 / $24,066.40 / $24,066.40	Facility		$132.63	$24,066.40	$24,066.40
Quartz Facility/Professional Professional Modifier Low / Median / High Price $198.87 / $814.50 / $842.96	Professional		$198.87	$814.50	$842.96
Security Health Facility/Professional Professional Modifier Low / Median / High Price $407.52 / $407.52 / $407.52	Professional		$407.52	$407.52	$407.52
Security Health Facility/Professional Professional Modifier Low / Median / High Price $372.26 / $559.70 / $559.70	Professional		$372.26	$559.70	$559.70
United Facility/Professional Facility Modifier Low / Median / High Price $6,073.00 / $9,882.00 / $12,631.00	Facility		$6,073.00	$9,882.00	$12,631.00
United Facility/Professional Professional Modifier Low / Median / High Price $117.29 / $233.02 / $494.80	Professional		$117.29	$233.02	$494.80