Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $603.24 / $1,327.43 / $14,482.00	Facility		$603.24	$1,327.43	$14,482.00
Aetna Facility/Professional Professional Modifier Low / Median / High Price $603.24 / $696.51 / $2,507.37	Professional		$603.24	$696.51	$2,507.37
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $6,538.00 / $9,948.00 / $15,579.70	Facility		$6,538.00	$9,948.00	$15,579.70
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $625.20 / $1,435.07 / $3,667.73	Professional		$625.20	$1,435.07	$3,667.73
Cigna Facility/Professional Facility Modifier Low / Median / High Price $1,691.40 / $1,976.54 / $3,032.06	Facility		$1,691.40	$1,976.54	$3,032.06
Cigna Facility/Professional Professional Modifier Low / Median / High Price $988.42 / $2,522.37 / $2,866.33	Professional		$988.42	$2,522.37	$2,866.33
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $603.24 / $844.54 / $1,398.80	Facility		$603.24	$844.54	$1,398.80
Medica Facility/Professional Facility Modifier Low / Median / High Price $603.24 / $1,085.83 / $13,250.00	Facility		$603.24	$1,085.83	$13,250.00
Medica Facility/Professional Professional Modifier Low / Median / High Price $682.10 / $1,250.53 / $4,930.88	Professional		$682.10	$1,250.53	$4,930.88
Molina Facility/Professional Professional Modifier Low / Median / High Price $62.33 / $521.87 / $1,362.62	Professional		$62.33	$521.87	$1,362.62
Prevea360 Facility/Professional Facility Modifier Low / Median / High Price $603.24 / $833.68 / $1,398.80	Facility		$603.24	$833.68	$1,398.80
Quartz Facility/Professional Professional Modifier Low / Median / High Price $1,343.55 / $1,637.06 / $2,443.81	Professional		$1,343.55	$1,637.06	$2,443.81
Quartz Facility/Professional Facility Modifier Low / Median / High Price $20,174.84 / $20,174.84 / $20,174.84	Facility		$20,174.84	$20,174.84	$20,174.84
Quartz Facility/Professional Professional Modifier Low / Median / High Price $1,267.21 / $3,176.55 / $4,930.88	Professional		$1,267.21	$3,176.55	$4,930.88
Security Health Facility/Professional Professional Modifier Low / Median / High Price $2,238.19 / $2,238.19 / $2,238.19	Professional		$2,238.19	$2,238.19	$2,238.19
Security Health Facility/Professional Professional Modifier Low / Median / High Price $2,096.94 / $3,476.81 / $3,776.97	Professional		$2,096.94	$3,476.81	$3,776.97
United Facility/Professional Facility Modifier Low / Median / High Price $7,301.00 / $11,608.00 / $13,980.00	Facility		$7,301.00	$11,608.00	$13,980.00
United Facility/Professional Professional Modifier Low / Median / High Price $701.12 / $1,235.04 / $2,716.32	Professional		$701.12	$1,235.04	$2,716.32