Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $161.22 / $655.65 / $1,894.00	Facility		$161.22	$655.65	$1,894.00
Aetna Facility/Professional Facility Modifier 53 Low / Median / High Price $32.25 / $80.08 / $247.81	Facility	53	$32.25	$80.08	$247.81
Aetna Facility/Professional Professional Modifier Low / Median / High Price $161.22 / $319.27 / $1,108.00	Professional		$161.22	$319.27	$1,108.00
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $2,740.00 / $4,780.00 / $7,344.00	Facility		$2,740.00	$4,780.00	$7,344.00
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $257.89 / $673.76 / $1,648.57	Professional		$257.89	$673.76	$1,648.57
Cigna Facility/Professional Facility Modifier Low / Median / High Price $966.00 / $1,128.84 / $1,820.79	Facility		$966.00	$1,128.84	$1,820.79
Cigna Facility/Professional Professional Modifier Low / Median / High Price $271.27 / $524.33 / $1,282.94	Professional		$271.27	$524.33	$1,282.94
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $161.22 / $339.89 / $664.33	Facility		$161.22	$339.89	$664.33
Medica Facility/Professional Facility Modifier Low / Median / High Price $173.62 / $451.39 / $8,129.86	Facility		$173.62	$451.39	$8,129.86
Medica Facility/Professional Professional Modifier Low / Median / High Price $334.19 / $854.40 / $1,755.00	Professional		$334.19	$854.40	$1,755.00
Molina Facility/Professional Professional Modifier Low / Median / High Price $85.00 / $382.55 / $839.42	Professional		$85.00	$382.55	$839.42
Prevea360 Facility/Professional Facility Modifier Low / Median / High Price $161.22 / $339.89 / $664.33	Facility		$161.22	$339.89	$664.33
Quartz Facility/Professional Professional Modifier Low / Median / High Price $348.83 / $618.24 / $1,143.31	Professional		$348.83	$618.24	$1,143.31
Quartz Facility/Professional Facility Modifier Low / Median / High Price $879.65 / $879.65 / $879.65	Facility		$879.65	$879.65	$879.65
Quartz Facility/Professional Facility Modifier 53 Low / Median / High Price $138.36 / $138.36 / $138.36	Facility	53	$138.36	$138.36	$138.36
Quartz Facility/Professional Professional Modifier Low / Median / High Price $252.16 / $1,529.73 / $2,665.36	Professional		$252.16	$1,529.73	$2,665.36
Security Health Facility/Professional Professional Modifier Low / Median / High Price $433.28 / $803.07 / $1,964.93	Professional		$433.28	$803.07	$1,964.93
United Facility/Professional Facility Modifier Low / Median / High Price $4,614.00 / $6,477.00 / $8,384.00	Facility		$4,614.00	$6,477.00	$8,384.00
United Facility/Professional Professional Modifier Low / Median / High Price $336.97 / $870.25 / $1,369.56	Professional		$336.97	$870.25	$1,369.56