Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $1,068.82 / $6,903.38 / $14,209.60	Facility		$1,068.82	$6,903.38	$14,209.60
Aetna Facility/Professional Facility Modifier 50 Low / Median / High Price $6,751.80 / $6,751.80 / $9,211.34	Facility	50	$6,751.80	$6,751.80	$9,211.34
Aetna Facility/Professional Professional Modifier Low / Median / High Price $468.33 / $632.36 / $2,690.59	Professional		$468.33	$632.36	$2,690.59
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $2,740.00 / $4,780.00 / $8,456.00	Facility		$2,740.00	$4,780.00	$8,456.00
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $490.86 / $1,160.46 / $2,937.32	Professional		$490.86	$1,160.46	$2,937.32
CareSource Facility/Professional Facility Modifier Low / Median / High Price $490.23 / $620.28 / $1,942.50	Facility		$490.23	$620.28	$1,942.50
CareSource Facility/Professional Professional Modifier Low / Median / High Price $471.72 / $495.31 / $667.04	Professional		$471.72	$495.31	$667.04
Cigna Facility/Professional Facility Modifier Low / Median / High Price $1,353.48 / $1,581.65 / $2,426.29	Facility		$1,353.48	$1,581.65	$2,426.29
Cigna Facility/Professional Professional Modifier Low / Median / High Price $756.16 / $2,064.82 / $2,346.39	Professional		$756.16	$2,064.82	$2,346.39
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $502.87 / $680.22 / $1,068.82	Facility		$502.87	$680.22	$1,068.82
Medica Facility/Professional Facility Modifier Low / Median / High Price $502.87 / $1,019.10 / $11,100.00	Facility		$502.87	$1,019.10	$11,100.00
Medica Facility/Professional Professional Modifier Low / Median / High Price $536.21 / $1,070.09 / $3,839.44	Professional		$536.21	$1,070.09	$3,839.44
Molina Facility/Professional Professional Modifier Low / Median / High Price $61.84 / $294.30 / $965.52	Professional		$61.84	$294.30	$965.52
Prevea360 Facility/Professional Facility Modifier Low / Median / High Price $502.87 / $680.22 / $1,068.82	Facility		$502.87	$680.22	$1,068.82
Quartz Facility/Professional Professional Modifier Low / Median / High Price $1,030.25 / $1,255.32 / $1,873.95	Professional		$1,030.25	$1,255.32	$1,873.95
Quartz Facility/Professional Facility Modifier Low / Median / High Price $1,722.47 / $1,722.47 / $5,350.00	Facility		$1,722.47	$1,722.47	$5,350.00
Quartz Facility/Professional Professional Modifier Low / Median / High Price $966.04 / $2,443.15 / $3,839.44	Professional		$966.04	$2,443.15	$3,839.44
Security Health Facility/Professional Professional Modifier Low / Median / High Price $1,207.94 / $2,532.86 / $3,286.07	Professional		$1,207.94	$2,532.86	$3,286.07
United Facility/Professional Facility Modifier Low / Median / High Price $4,240.00 / $9,158.00 / $12,062.00	Facility		$4,240.00	$9,158.00	$12,062.00
United Facility/Professional Professional Modifier Low / Median / High Price $491.36 / $1,621.49 / $2,952.59	Professional		$491.36	$1,621.49	$2,952.59