Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $560.09 / $1,704.85 / $8,243.00	Facility		$560.09	$1,704.85	$8,243.00
Aetna Facility/Professional Facility Modifier 50 Low / Median / High Price $2,790.46 / $2,790.46 / $2,790.46	Facility	50	$2,790.46	$2,790.46	$2,790.46
Aetna Facility/Professional Professional Modifier Low / Median / High Price $560.09 / $715.17 / $1,711.34	Professional		$560.09	$715.17	$1,711.34
Aetna Facility/Professional Professional Modifier 50 Low / Median / High Price $288.10 / $4,348.17 / $7,939.00	Professional	50	$288.10	$4,348.17	$7,939.00
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $5,060.00 / $7,344.00 / $10,517.23	Facility		$5,060.00	$7,344.00	$10,517.23
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $870.23 / $1,922.82 / $3,715.58	Professional		$870.23	$1,922.82	$3,715.58
Anthem BCBS Facility/Professional Professional Modifier 50 Low / Median / High Price $1,356.00 / $2,976.81 / $5,626.66	Professional	50	$1,356.00	$2,976.81	$5,626.66
Cigna Facility/Professional Facility Modifier Low / Median / High Price $2,182.51 / $2,550.44 / $4,113.77	Facility		$2,182.51	$2,550.44	$4,113.77
Cigna Facility/Professional Professional Modifier Low / Median / High Price $1,262.45 / $1,941.20 / $3,188.48	Professional		$1,262.45	$1,941.20	$3,188.48
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $607.82 / $904.13 / $1,629.08	Facility		$607.82	$904.13	$1,629.08
Medica Facility/Professional Facility Modifier Low / Median / High Price $674.12 / $1,248.69 / $8,384.00	Facility		$674.12	$1,248.69	$8,384.00
Medica Facility/Professional Facility Modifier 50 Low / Median / High Price $3,574.80 / $3,574.80 / $3,574.80	Facility	50	$3,574.80	$3,574.80	$3,574.80
Medica Facility/Professional Professional Modifier Low / Median / High Price $955.38 / $2,409.60 / $4,973.20	Professional		$955.38	$2,409.60	$4,973.20
Molina Facility/Professional Professional Modifier Low / Median / High Price $70.00 / $514.34 / $1,676.87	Professional		$70.00	$514.34	$1,676.87
Prevea360 Facility/Professional Facility Modifier Low / Median / High Price $607.82 / $904.13 / $1,629.08	Facility		$607.82	$904.13	$1,629.08
Quartz Facility/Professional Professional Modifier Low / Median / High Price $1,501.06 / $2,052.58 / $2,830.74	Professional		$1,501.06	$2,052.58	$2,830.74
Quartz Facility/Professional Facility Modifier Low / Median / High Price $4,731.12 / $4,731.12 / $4,731.12	Facility		$4,731.12	$4,731.12	$4,731.12
Quartz Facility/Professional Professional Modifier Low / Median / High Price $1,285.39 / $3,490.25 / $6,141.92	Professional		$1,285.39	$3,490.25	$6,141.92
Security Health Facility/Professional Professional Modifier Low / Median / High Price $1,220.30 / $2,840.62 / $3,530.93	Professional		$1,220.30	$2,840.62	$3,530.93
United Facility/Professional Facility Modifier Low / Median / High Price $4,614.00 / $6,477.00 / $8,384.00	Facility		$4,614.00	$6,477.00	$8,384.00
United Facility/Professional Professional Modifier Low / Median / High Price $938.66 / $1,955.32 / $3,345.82	Professional		$938.66	$1,955.32	$3,345.82