Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $21.00 / $21.00 / $21.00	Facility		$21.00	$21.00	$21.00
Aetna Facility/Professional Professional Modifier Low / Median / High Price $21.00 / $21.00 / $26.25	Professional		$21.00	$21.00	$26.25
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $204.10 / $366.11 / $806.61	Professional		$204.10	$366.11	$806.61
Cigna Facility/Professional Facility Modifier Low / Median / High Price $174.33 / $657.41 / $1,037.07	Facility		$174.33	$657.41	$1,037.07
Cigna Facility/Professional Professional Modifier Low / Median / High Price $174.33 / $385.28 / $437.81	Professional		$174.33	$385.28	$437.81
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $21.00 / $22.31 / $251.21	Facility		$21.00	$22.31	$251.21
DeanCare Facility/Professional Professional Modifier Low / Median / High Price $171.82 / $171.82 / $171.82	Professional		$171.82	$171.82	$171.82
Medica Facility/Professional Facility Modifier Low / Median / High Price $21.00 / $209.98 / $251.21	Facility		$21.00	$209.98	$251.21
Medica Facility/Professional Professional Modifier Low / Median / High Price $124.52 / $195.92 / $457.53	Professional		$124.52	$195.92	$457.53
Molina Facility/Professional Professional Modifier Low / Median / High Price $50.00 / $65.00 / $751.74	Professional		$50.00	$65.00	$751.74
Prevea360 Facility/Professional Facility Modifier Low / Median / High Price $21.00 / $22.31 / $251.21	Facility		$21.00	$22.31	$251.21
Prevea360 Facility/Professional Professional Modifier Low / Median / High Price $171.82 / $171.82 / $171.82	Professional		$171.82	$171.82	$171.82
Quartz Facility/Professional Professional Modifier Low / Median / High Price $395.68 / $500.10 / $697.40	Professional		$395.68	$500.10	$697.40
Quartz Facility/Professional Facility Modifier Low / Median / High Price $1,122.17 / $1,122.17 / $1,122.17	Facility		$1,122.17	$1,122.17	$1,122.17
Quartz Facility/Professional Professional Modifier Low / Median / High Price $174.33 / $1,085.70 / $1,375.72	Professional		$174.33	$1,085.70	$1,375.72
United Facility/Professional Professional Modifier Low / Median / High Price $118.08 / $139.03 / $251.13	Professional		$118.08	$139.03	$251.13