Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $490.08 / $490.08 / $1,092.88	Facility		$490.08	$490.08	$1,092.88
Aetna Facility/Professional Professional Modifier Low / Median / High Price $490.08 / $490.08 / $612.60	Professional		$490.08	$490.08	$612.60
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $998.83 / $1,160.81 / $1,204.00	Facility		$998.83	$1,160.81	$1,204.00
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $510.50 / $510.50 / $520.71	Professional		$510.50	$510.50	$520.71
Cigna Facility/Professional Facility Modifier Low / Median / High Price $510.50 / $612.60 / $1,393.97	Facility		$510.50	$612.60	$1,393.97
Cigna Facility/Professional Professional Modifier Low / Median / High Price $510.49 / $525.79 / $638.11	Professional		$510.49	$525.79	$638.11
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $490.08 / $612.60 / $612.60	Facility		$490.08	$612.60	$612.60
Medica Facility/Professional Facility Modifier Low / Median / High Price $490.08 / $539.69 / $612.60	Facility		$490.08	$539.69	$612.60
Medica Facility/Professional Professional Modifier Low / Median / High Price $510.50 / $510.50 / $663.65	Professional		$510.50	$510.50	$663.65
Molina Facility/Professional Professional Modifier Low / Median / High Price $50.00 / $85.00 / $1,960.09	Professional		$50.00	$85.00	$1,960.09
Prevea360 Facility/Professional Facility Modifier Low / Median / High Price $490.08 / $612.60 / $612.60	Facility		$490.08	$612.60	$612.60
Quartz Facility/Professional Facility Modifier Low / Median / High Price $520.71 / $520.71 / $2,705.65	Facility		$520.71	$520.71	$2,705.65
Quartz Facility/Professional Professional Modifier Low / Median / High Price $520.71 / $520.71 / $520.71	Professional		$520.71	$520.71	$520.71
United Facility/Professional Professional Modifier Low / Median / High Price $510.50 / $510.50 / $663.65	Professional		$510.50	$510.50	$663.65