Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $200.26 / $529.20 / $13,759.96	Facility		$200.26	$529.20	$13,759.96
Aetna Facility/Professional Facility Modifier 50 Low / Median / High Price $4,423.55 / $4,423.55 / $4,423.55	Facility	50	$4,423.55	$4,423.55	$4,423.55
Aetna Facility/Professional Professional Modifier Low / Median / High Price $180.59 / $305.75 / $943.15	Professional		$180.59	$305.75	$943.15
Aetna Facility/Professional Professional Modifier 50 Low / Median / High Price $465.96 / $1,387.31 / $1,890.48	Professional	50	$465.96	$1,387.31	$1,890.48
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 $242.96 / $573.28 / $1,343.40	Professional		$242.96	$573.28	$1,343.40
Anthem BCBS Facility/Professional Professional Modifier 50 Low / Median / High Price $364.44 / $859.92 / $2,031.03	Professional	50	$364.44	$859.92	$2,031.03
Cigna Facility/Professional Facility Modifier Low / Median / High Price $663.22 / $775.03 / $1,250.09	Facility		$663.22	$775.03	$1,250.09
Cigna Facility/Professional Professional Modifier Low / Median / High Price $277.08 / $574.77 / $876.61	Professional		$277.08	$574.77	$876.61
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $194.07 / $305.75 / $567.00	Facility		$194.07	$305.75	$567.00
Medica Facility/Professional Facility Modifier Low / Median / High Price $200.26 / $444.35 / $5,261.00	Facility		$200.26	$444.35	$5,261.00
Medica Facility/Professional Facility Modifier 50 Low / Median / High Price $4,070.70 / $4,070.70 / $4,070.70	Facility	50	$4,070.70	$4,070.70	$4,070.70
Medica Facility/Professional Professional Modifier Low / Median / High Price $310.45 / $854.59 / $2,164.00	Professional		$310.45	$854.59	$2,164.00
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 $194.07 / $305.75 / $567.00	Facility		$194.07	$305.75	$567.00
Quartz Facility/Professional Professional Modifier Low / Median / High Price $383.64 / $590.03 / $913.92	Professional		$383.64	$590.03	$913.92
Quartz Facility/Professional Facility Modifier Low / Median / High Price $1,171.38 / $1,171.38 / $1,171.38	Facility		$1,171.38	$1,171.38	$1,171.38
Quartz Facility/Professional Professional Modifier Low / Median / High Price $231.23 / $1,059.57 / $2,210.82	Professional		$231.23	$1,059.57	$2,210.82
Security Health Facility/Professional Professional Modifier Low / Median / High Price $633.26 / $992.23 / $1,505.53	Professional		$633.26	$992.23	$1,505.53
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 $282.37 / $737.85 / $1,072.61	Professional		$282.37	$737.85	$1,072.61