Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $587.63 / $587.63 / $8,258.04	Facility		$587.63	$587.63	$8,258.04
Aetna Facility/Professional Professional Modifier Low / Median / High Price $587.63 / $594.98 / $634.29	Professional		$587.63	$594.98	$634.29
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $704.87 / $819.17 / $849.65	Facility		$704.87	$819.17	$849.65
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $612.11 / $612.11 / $612.11	Professional		$612.11	$612.11	$612.11
Cigna Facility/Professional Facility Modifier Low / Median / High Price $482.48 / $882.65 / $1,251.02	Facility		$482.48	$882.65	$1,251.02
Cigna Facility/Professional Professional Modifier Low / Median / High Price $624.36 / $624.36 / $624.36	Professional		$624.36	$624.36	$624.36
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $587.63 / $609.66 / $988.80	Facility		$587.63	$609.66	$988.80
Medica Facility/Professional Facility Modifier Low / Median / High Price $791.04 / $840.48 / $4,356.30	Facility		$791.04	$840.48	$4,356.30
Medica Facility/Professional Professional Modifier Low / Median / High Price $612.11 / $612.11 / $1,285.43	Professional		$612.11	$612.11	$1,285.43
Molina Facility/Professional Professional Modifier Low / Median / High Price $50.00 / $70.00 / $3,310.56	Professional		$50.00	$70.00	$3,310.56
Prevea360 Facility/Professional Facility Modifier Low / Median / High Price $587.63 / $594.98 / $988.80	Facility		$587.63	$594.98	$988.80
Quartz Facility/Professional Professional Modifier Low / Median / High Price $5,900.00 / $5,900.00 / $5,900.00	Professional		$5,900.00	$5,900.00	$5,900.00
Quartz Facility/Professional Facility Modifier Low / Median / High Price $840.48 / $3,485.04 / $4,356.30	Facility		$840.48	$3,485.04	$4,356.30
Quartz Facility/Professional Professional Modifier Low / Median / High Price $624.36 / $1,048.13 / $3,757.44	Professional		$624.36	$1,048.13	$3,757.44
United Facility/Professional Professional Modifier Low / Median / High Price $612.11 / $612.11 / $734.54	Professional		$612.11	$612.11	$734.54