Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $555.27 / $3,485.72 / $5,282.87	Facility		$555.27	$3,485.72	$5,282.87
Aetna Facility/Professional Facility Modifier 50 Low / Median / High Price $4,678.50 / $4,678.50 / $4,678.50	Facility	50	$4,678.50	$4,678.50	$4,678.50
Aetna Facility/Professional Professional Modifier Low / Median / High Price $131.22 / $579.04 / $3,204.50	Professional		$131.22	$579.04	$3,204.50
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $1,905.00 / $3,496.00 / $5,962.00	Facility		$1,905.00	$3,496.00	$5,962.00
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $288.81 / $734.59 / $2,349.79	Professional		$288.81	$734.59	$2,349.79
CareSource Facility/Professional Facility Modifier Low / Median / High Price $143.60 / $217.08 / $217.08	Facility		$143.60	$217.08	$217.08
CareSource Facility/Professional Professional Modifier Low / Median / High Price $454.69 / $629.88 / $973.61	Professional		$454.69	$629.88	$973.61
Cigna Facility/Professional Facility Modifier Low / Median / High Price $1,338.16 / $1,563.75 / $2,522.27	Facility		$1,338.16	$1,563.75	$2,522.27
Cigna Facility/Professional Professional Modifier Low / Median / High Price $285.24 / $622.78 / $1,729.08	Professional		$285.24	$622.78	$1,729.08
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $138.47 / $322.32 / $867.33	Facility		$138.47	$322.32	$867.33
Medica Facility/Professional Facility Modifier Low / Median / High Price $177.24 / $1,199.42 / $5,261.00	Facility		$177.24	$1,199.42	$5,261.00
Medica Facility/Professional Professional Modifier Low / Median / High Price $679.84 / $1,681.13 / $2,601.26	Professional		$679.84	$1,681.13	$2,601.26
Molina Facility/Professional Professional Modifier Low / Median / High Price $85.00 / $518.11 / $1,188.78	Professional		$85.00	$518.11	$1,188.78
Prevea360 Facility/Professional Facility Modifier Low / Median / High Price $138.47 / $322.32 / $867.33	Facility		$138.47	$322.32	$867.33
Quartz Facility/Professional Professional Modifier Low / Median / High Price $345.77 / $631.32 / $1,702.51	Professional		$345.77	$631.32	$1,702.51
Quartz Facility/Professional Facility Modifier Low / Median / High Price $709.04 / $709.04 / $709.04	Facility		$709.04	$709.04	$709.04
Quartz Facility/Professional Professional Modifier Low / Median / High Price $292.25 / $1,284.25 / $3,659.84	Professional		$292.25	$1,284.25	$3,659.84
Security Health Facility/Professional Professional Modifier Low / Median / High Price $561.41 / $1,040.00 / $2,135.27	Professional		$561.41	$1,040.00	$2,135.27
United Facility/Professional Facility Modifier Low / Median / High Price $2,976.00 / $4,155.00 / $5,865.00	Facility		$2,976.00	$4,155.00	$5,865.00
United Facility/Professional Professional Modifier Low / Median / High Price $655.24 / $1,595.53 / $2,568.92	Professional		$655.24	$1,595.53	$2,568.92