Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $386.26 / $653.45 / $14,482.00	Facility		$386.26	$653.45	$14,482.00
Aetna Facility/Professional Facility Modifier 50 Low / Median / High Price $2,461.23 / $12,699.00 / $16,060.90	Facility	50	$2,461.23	$12,699.00	$16,060.90
Aetna Facility/Professional Professional Modifier Low / Median / High Price $341.26 / $386.26 / $1,164.58	Professional		$341.26	$386.26	$1,164.58
Aetna Facility/Professional Professional Modifier 50 Low / Median / High Price $703.10 / $2,723.37 / $5,199.60	Professional	50	$703.10	$2,723.37	$5,199.60
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $5,479.00 / $11,777.00 / $19,639.00	Facility		$5,479.00	$11,777.00	$19,639.00
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $312.89 / $906.12 / $2,021.23	Professional		$312.89	$906.12	$2,021.23
Anthem BCBS Facility/Professional Professional Modifier 50 Low / Median / High Price $469.33 / $1,359.18 / $3,031.85	Professional	50	$469.33	$1,359.18	$3,031.85
Cigna Facility/Professional Facility Modifier Low / Median / High Price $822.72 / $961.42 / $1,550.73	Facility		$822.72	$961.42	$1,550.73
Cigna Facility/Professional Professional Modifier Low / Median / High Price $460.15 / $975.37 / $1,319.32	Professional		$460.15	$975.37	$1,319.32
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $348.50 / $472.82 / $2,616.56	Facility		$348.50	$472.82	$2,616.56
Medica Facility/Professional Facility Modifier Low / Median / High Price $355.07 / $2,619.90 / $12,631.00	Facility		$355.07	$2,619.90	$12,631.00
Medica Facility/Professional Facility Modifier 50 Low / Median / High Price $1,535.94 / $1,535.94 / $1,535.94	Facility	50	$1,535.94	$1,535.94	$1,535.94
Medica Facility/Professional Professional Modifier Low / Median / High Price $376.94 / $1,074.92 / $6,125.60	Professional		$376.94	$1,074.92	$6,125.60
Molina Facility/Professional Professional Modifier Low / Median / High Price $85.00 / $531.30 / $783.93	Professional		$85.00	$531.30	$783.93
Prevea360 Facility/Professional Facility Modifier Low / Median / High Price $348.50 / $472.82 / $2,616.56	Facility		$348.50	$472.82	$2,616.56
Quartz Facility/Professional Professional Modifier Low / Median / High Price $627.90 / $969.57 / $1,262.40	Professional		$627.90	$969.57	$1,262.40
Quartz Facility/Professional Facility Modifier Low / Median / High Price $13,759.35 / $13,759.35 / $13,759.35	Facility		$13,759.35	$13,759.35	$13,759.35
Quartz Facility/Professional Professional Modifier Low / Median / High Price $443.59 / $1,717.25 / $6,125.60	Professional		$443.59	$1,717.25	$6,125.60
Security Health Facility/Professional Professional Modifier Low / Median / High Price $985.29 / $1,903.53 / $1,903.53	Professional		$985.29	$1,903.53	$1,903.53
United Facility/Professional Facility Modifier Low / Median / High Price $6,073.00 / $9,953.00 / $12,631.00	Facility		$6,073.00	$9,953.00	$12,631.00
United Facility/Professional Professional Modifier Low / Median / High Price $373.88 / $1,103.00 / $1,392.72	Professional		$373.88	$1,103.00	$1,392.72