Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $1,164.82 / $8,768.32 / $15,877.90	Facility		$1,164.82	$8,768.32	$15,877.90
Aetna Facility/Professional Facility Modifier 50 Low / Median / High Price $22,822.38 / $22,822.38 / $22,822.38	Facility	50	$22,822.38	$22,822.38	$22,822.38
Aetna Facility/Professional Professional Modifier Low / Median / High Price $504.04 / $1,184.33 / $6,163.42	Professional		$504.04	$1,184.33	$6,163.42
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $5,060.00 / $8,139.00 / $11,136.00	Facility		$5,060.00	$8,139.00	$11,136.00
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $518.00 / $1,081.35 / $3,249.65	Professional		$518.00	$1,081.35	$3,249.65
CareSource Facility/Professional Facility Modifier Low / Median / High Price $516.07 / $651.84 / $3,462.54	Facility		$516.07	$651.84	$3,462.54
CareSource Facility/Professional Professional Modifier Low / Median / High Price $494.35 / $519.07 / $702.28	Professional		$494.35	$519.07	$702.28
Cigna Facility/Professional Facility Modifier Low / Median / High Price $1,416.56 / $1,655.36 / $2,539.37	Facility		$1,416.56	$1,655.36	$2,539.37
Cigna Facility/Professional Professional Modifier Low / Median / High Price $838.46 / $2,165.28 / $2,460.55	Professional		$838.46	$2,165.28	$2,460.55
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $528.64 / $792.96 / $1,607.68	Facility		$528.64	$792.96	$1,607.68
Medica Facility/Professional Facility Modifier Low / Median / High Price $551.84 / $1,378.36 / $10,843.00	Facility		$551.84	$1,378.36	$10,843.00
Medica Facility/Professional Professional Modifier Low / Median / High Price $617.30 / $1,162.01 / $5,283.53	Professional		$617.30	$1,162.01	$5,283.53
Molina Facility/Professional Professional Modifier Low / Median / High Price $61.81 / $316.93 / $1,001.80	Professional		$61.81	$316.93	$1,001.80
Prevea360 Facility/Professional Facility Modifier Low / Median / High Price $528.64 / $792.96 / $1,607.68	Facility		$528.64	$792.96	$1,607.68
Quartz Facility/Professional Professional Modifier Low / Median / High Price $1,081.59 / $1,317.89 / $1,967.35	Professional		$1,081.59	$1,317.89	$1,967.35
Quartz Facility/Professional Facility Modifier Low / Median / High Price $3,244.77 / $3,244.77 / $8,957.00	Facility		$3,244.77	$3,244.77	$8,957.00
Quartz Facility/Professional Facility Modifier AS Low / Median / High Price $849.00 / $849.00 / $849.00	Facility	AS	$849.00	$849.00	$849.00
Quartz Facility/Professional Professional Modifier Low / Median / High Price $1,013.03 / $2,589.73 / $5,283.53	Professional		$1,013.03	$2,589.73	$5,283.53
Security Health Facility/Professional Professional Modifier Low / Median / High Price $1,745.12 / $2,756.89 / $3,993.45	Professional		$1,745.12	$2,756.89	$3,993.45
United Facility/Professional Facility Modifier Low / Median / High Price $6,241.00 / $9,837.00 / $12,062.00	Facility		$6,241.00	$9,837.00	$12,062.00
United Facility/Professional Professional Modifier Low / Median / High Price $597.74 / $1,091.67 / $2,426.71	Professional		$597.74	$1,091.67	$2,426.71