Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $575.44 / $575.44 / $3,963.35	Facility		$575.44	$575.44	$3,963.35
Aetna Facility/Professional Professional Modifier Low / Median / High Price $575.44 / $575.44 / $719.30	Professional		$575.44	$575.44	$719.30
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $643.86 / $1,096.57 / $2,628.51	Professional		$643.86	$1,096.57	$2,628.51
Cigna Facility/Professional Facility Modifier Low / Median / High Price $611.41 / $1,800.19 / $2,839.83	Facility		$611.41	$1,800.19	$2,839.83
Cigna Facility/Professional Professional Modifier Low / Median / High Price $611.41 / $883.59 / $1,004.08	Professional		$611.41	$883.59	$1,004.08
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $505.08 / $575.44 / $719.30	Facility		$505.08	$575.44	$719.30
Medica Facility/Professional Facility Modifier Low / Median / High Price $505.08 / $575.44 / $719.30	Facility		$505.08	$575.44	$719.30
Medica Facility/Professional Professional Modifier Low / Median / High Price $683.34 / $683.34 / $1,093.33	Professional		$683.34	$683.34	$1,093.33
Molina Facility/Professional Professional Modifier Low / Median / High Price $55.00 / $85.00 / $2,262.94	Professional		$55.00	$85.00	$2,262.94
Prevea360 Facility/Professional Facility Modifier Low / Median / High Price $505.08 / $575.44 / $719.30	Facility		$505.08	$575.44	$719.30
Quartz Facility/Professional Professional Modifier Low / Median / High Price $19.76 / $1,402.99 / $2,065.66	Professional		$19.76	$1,402.99	$2,065.66
Quartz Facility/Professional Facility Modifier Low / Median / High Price $3,219.63 / $3,219.63 / $3,219.63	Facility		$3,219.63	$3,219.63	$3,219.63
Quartz Facility/Professional Professional Modifier Low / Median / High Price $611.41 / $3,223.98 / $3,503.62	Professional		$611.41	$3,223.98	$3,503.62
United Facility/Professional Professional Modifier Low / Median / High Price $683.34 / $683.34 / $1,025.01	Professional		$683.34	$683.34	$1,025.01