Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $60.00 / $60.00 / $133.80	Facility		$60.00	$60.00	$133.80
Aetna Facility/Professional Professional Modifier Low / Median / High Price $60.00 / $60.00 / $75.00	Professional		$60.00	$60.00	$75.00
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $125.13 / $145.43 / $150.84	Facility		$125.13	$145.43	$150.84
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $62.50 / $1,466.62 / $5,122.10	Professional		$62.50	$1,466.62	$5,122.10
Cigna Facility/Professional Facility Modifier Low / Median / High Price $63.75 / $167.98 / $240.11	Facility		$63.75	$167.98	$240.11
Cigna Facility/Professional Professional Modifier Low / Median / High Price $70.50 / $2,667.46 / $3,031.20	Professional		$70.50	$2,667.46	$3,031.20
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $60.00 / $75.00 / $1,783.04	Facility		$60.00	$75.00	$1,783.04
DeanCare Facility/Professional Professional Modifier Low / Median / High Price $36.88 / $36.88 / $36.88	Professional		$36.88	$36.88	$36.88
Medica Facility/Professional Facility Modifier Low / Median / High Price $60.00 / $91.37 / $1,783.04	Facility		$60.00	$91.37	$1,783.04
Medica Facility/Professional Professional Modifier Low / Median / High Price $62.50 / $62.50 / $93.75	Professional		$62.50	$62.50	$93.75
Molina Facility/Professional Professional Modifier Low / Median / High Price $55.00 / $65.00 / $537.89	Professional		$55.00	$65.00	$537.89
Prevea360 Facility/Professional Facility Modifier Low / Median / High Price $60.00 / $75.00 / $1,783.04	Facility		$60.00	$75.00	$1,783.04
Prevea360 Facility/Professional Professional Modifier Low / Median / High Price $36.88 / $36.88 / $36.88	Professional		$36.88	$36.88	$36.88
Quartz Facility/Professional Professional Modifier Low / Median / High Price $1,726.56 / $3,660.96 / $5,280.00	Professional		$1,726.56	$3,660.96	$5,280.00
Quartz Facility/Professional Facility Modifier Low / Median / High Price $63.75 / $63.75 / $2,551.37	Facility		$63.75	$63.75	$2,551.37
Quartz Facility/Professional Professional Modifier Low / Median / High Price $63.75 / $63.75 / $63.75	Professional		$63.75	$63.75	$63.75
Security Health Facility/Professional Professional Modifier Low / Median / High Price $2,902.63 / $2,902.63 / $5,307.06	Professional		$2,902.63	$2,902.63	$5,307.06
United Facility/Professional Professional Modifier Low / Median / High Price $62.50 / $62.50 / $93.75	Professional		$62.50	$62.50	$93.75