Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $127.98 / $986.45 / $14,482.00	Facility		$127.98	$986.45	$14,482.00
Aetna Facility/Professional Facility Modifier 52 Low / Median / High Price $63.99 / $212.45 / $879.03	Facility	52	$63.99	$212.45	$879.03
Aetna Facility/Professional Professional Modifier Low / Median / High Price $114.59 / $424.90 / $613.62	Professional		$114.59	$424.90	$613.62
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $1,905.00 / $3,193.00 / $5,962.00	Facility		$1,905.00	$3,193.00	$5,962.00
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $169.55 / $618.23 / $2,605.29	Professional		$169.55	$618.23	$2,605.29
Cigna Facility/Professional Facility Modifier Low / Median / High Price $1,335.46 / $1,560.59 / $2,393.98	Facility		$1,335.46	$1,560.59	$2,393.98
Cigna Facility/Professional Facility Modifier 52 Low / Median / High Price $157.86 / $157.86 / $157.86	Facility	52	$157.86	$157.86	$157.86
Cigna Facility/Professional Professional Modifier Low / Median / High Price $189.14 / $478.24 / $2,047.66	Professional		$189.14	$478.24	$2,047.66
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $118.31 / $367.50 / $824.10	Facility		$118.31	$367.50	$824.10
Medica Facility/Professional Facility Modifier Low / Median / High Price $118.31 / $459.59 / $3,242.00	Facility		$118.31	$459.59	$3,242.00
Medica Facility/Professional Facility Modifier 52 Low / Median / High Price $422.66 / $422.66 / $422.66	Facility	52	$422.66	$422.66	$422.66
Medica Facility/Professional Professional Modifier Low / Median / High Price $223.50 / $1,747.60 / $3,618.00	Professional		$223.50	$1,747.60	$3,618.00
Molina Facility/Professional Professional Modifier Low / Median / High Price $85.00 / $523.75 / $1,109.04	Professional		$85.00	$523.75	$1,109.04
Prevea360 Facility/Professional Facility Modifier Low / Median / High Price $118.31 / $367.50 / $824.10	Facility		$118.31	$367.50	$824.10
Quartz Facility/Professional Professional Modifier Low / Median / High Price $260.63 / $537.16 / $1,615.96	Professional		$260.63	$537.16	$1,615.96
Quartz Facility/Professional Facility Modifier Low / Median / High Price $197.32 / $872.52 / $3,590.15	Facility		$197.32	$872.52	$3,590.15
Quartz Facility/Professional Facility Modifier 52 Low / Median / High Price $157.86 / $422.66 / $422.66	Facility	52	$157.86	$422.66	$422.66
Quartz Facility/Professional Professional Modifier Low / Median / High Price $223.97 / $1,826.92 / $3,618.00	Professional		$223.97	$1,826.92	$3,618.00
Security Health Facility/Professional Professional Modifier Low / Median / High Price $469.75 / $602.25 / $2,500.19	Professional		$469.75	$602.25	$2,500.19
United Facility/Professional Facility Modifier Low / Median / High Price $2,976.00 / $3,827.00 / $5,471.00	Facility		$2,976.00	$3,827.00	$5,471.00
United Facility/Professional Professional Modifier Low / Median / High Price $227.09 / $1,020.94 / $2,316.00	Professional		$227.09	$1,020.94	$2,316.00