Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $120.00 / $120.00 / $267.60	Facility		$120.00	$120.00	$267.60
Aetna Facility/Professional Professional Modifier Low / Median / High Price $120.00 / $120.00 / $150.00	Professional		$120.00	$120.00	$150.00
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $243.05 / $282.47 / $292.98	Facility		$243.05	$282.47	$292.98
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $125.00 / $125.00 / $127.50	Professional		$125.00	$125.00	$127.50
Cigna Facility/Professional Facility Modifier Low / Median / High Price $72.80 / $132.06 / $188.77	Facility		$72.80	$132.06	$188.77
Cigna Facility/Professional Professional Modifier Low / Median / High Price $127.50 / $127.50 / $127.50	Professional		$127.50	$127.50	$127.50
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $120.00 / $150.00 / $150.00	Facility		$120.00	$150.00	$150.00
Medica Facility/Professional Facility Modifier Low / Median / High Price $120.00 / $131.56 / $150.00	Facility		$120.00	$131.56	$150.00
Medica Facility/Professional Professional Modifier Low / Median / High Price $125.00 / $125.00 / $162.50	Professional		$125.00	$125.00	$162.50
Molina Facility/Professional Professional Modifier Low / Median / High Price $85.00 / $85.00 / $1,054.95	Professional		$85.00	$85.00	$1,054.95
Prevea360 Facility/Professional Facility Modifier Low / Median / High Price $120.00 / $150.00 / $150.00	Facility		$120.00	$150.00	$150.00
Quartz Facility/Professional Facility Modifier Low / Median / High Price $127.50 / $127.50 / $1,457.50	Facility		$127.50	$127.50	$1,457.50
Quartz Facility/Professional Professional Modifier Low / Median / High Price $127.50 / $127.50 / $127.50	Professional		$127.50	$127.50	$127.50
United Facility/Professional Professional Modifier Low / Median / High Price $125.00 / $125.00 / $171.15	Professional		$125.00	$125.00	$171.15