Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $299.39 / $647.58 / $10,434.86	Facility		$299.39	$647.58	$10,434.86
Aetna Facility/Professional Facility Modifier 50 Low / Median / High Price $179.75 / $1,668.30 / $9,362.83	Facility	50	$179.75	$1,668.30	$9,362.83
Aetna Facility/Professional Professional Modifier Low / Median / High Price $202.99 / $363.45 / $1,262.83	Professional		$202.99	$363.45	$1,262.83
Aetna Facility/Professional Professional Modifier 50 Low / Median / High Price $193.26 / $1,048.58 / $3,942.40	Professional	50	$193.26	$1,048.58	$3,942.40
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $2,740.00 / $4,780.00 / $7,344.00	Facility		$2,740.00	$4,780.00	$7,344.00
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $258.98 / $499.93 / $1,337.57	Professional		$258.98	$499.93	$1,337.57
Anthem BCBS Facility/Professional Professional Modifier 50 Low / Median / High Price $388.47 / $749.89 / $2,006.35	Professional	50	$388.47	$749.89	$2,006.35
CareSource Facility/Professional Facility Modifier Low / Median / High Price $168.61 / $254.73 / $254.73	Facility		$168.61	$254.73	$254.73
CareSource Facility/Professional Professional Modifier Low / Median / High Price $279.80 / $401.96 / $621.30	Professional		$279.80	$401.96	$621.30
Cigna Facility/Professional Facility Modifier Low / Median / High Price $788.48 / $921.40 / $1,486.19	Facility		$788.48	$921.40	$1,486.19
Cigna Facility/Professional Professional Modifier Low / Median / High Price $328.76 / $610.61 / $1,041.99	Professional		$328.76	$610.61	$1,041.99
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $202.99 / $347.20 / $606.29	Facility		$202.99	$347.20	$606.29
Medica Facility/Professional Facility Modifier Low / Median / High Price $213.86 / $581.49 / $8,384.00	Facility		$213.86	$581.49	$8,384.00
Medica Facility/Professional Facility Modifier 50 Low / Median / High Price $1,493.36 / $2,460.42 / $7,440.91	Facility	50	$1,493.36	$2,460.42	$7,440.91
Medica Facility/Professional Professional Modifier Low / Median / High Price $352.10 / $932.81 / $2,045.54	Professional		$352.10	$932.81	$2,045.54
Molina Facility/Professional Professional Modifier Low / Median / High Price $85.00 / $436.79 / $664.74	Professional		$85.00	$436.79	$664.74
Prevea360 Facility/Professional Facility Modifier Low / Median / High Price $206.71 / $347.20 / $606.29	Facility		$206.71	$347.20	$606.29
Quartz Facility/Professional Professional Modifier Low / Median / High Price $409.57 / $678.57 / $1,051.06	Professional		$409.57	$678.57	$1,051.06
Quartz Facility/Professional Facility Modifier Low / Median / High Price $1,246.32 / $1,246.32 / $1,246.32	Facility		$1,246.32	$1,246.32	$1,246.32
Quartz Facility/Professional Professional Modifier Low / Median / High Price $246.04 / $855.15 / $3,761.00	Professional		$246.04	$855.15	$3,761.00
Security Health Facility/Professional Professional Modifier Low / Median / High Price $1,055.80 / $1,081.58 / $1,785.03	Professional		$1,055.80	$1,081.58	$1,785.03
United Facility/Professional Facility Modifier Low / Median / High Price $4,918.00 / $6,477.00 / $8,384.00	Facility		$4,918.00	$6,477.00	$8,384.00
United Facility/Professional Professional Modifier Low / Median / High Price $307.33 / $847.64 / $1,219.19	Professional		$307.33	$847.64	$1,219.19