Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $356.60 / $3,119.00 / $10,105.59	Facility		$356.60	$3,119.00	$10,105.59
Aetna Facility/Professional Facility Modifier 52 Low / Median / High Price $105.20 / $228.41 / $679.62	Facility	52	$105.20	$228.41	$679.62
Aetna Facility/Professional Professional Modifier Low / Median / High Price $169.06 / $377.19 / $1,418.56	Professional		$169.06	$377.19	$1,418.56
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $1,979.00 / $6,787.00 / $10,517.23	Facility		$1,979.00	$6,787.00	$10,517.23
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $315.39 / $725.42 / $1,973.75	Professional		$315.39	$725.42	$1,973.75
CareSource Facility/Professional Facility Modifier Low / Median / High Price $163.12 / $245.79 / $245.79	Facility		$163.12	$245.79	$245.79
CareSource Facility/Professional Professional Modifier Low / Median / High Price $348.94 / $489.63 / $756.82	Professional		$348.94	$489.63	$756.82
Cigna Facility/Professional Facility Modifier Low / Median / High Price $997.54 / $1,165.70 / $1,880.24	Facility		$997.54	$1,165.70	$1,880.24
Cigna Facility/Professional Professional Modifier Low / Median / High Price $295.08 / $605.66 / $1,312.51	Professional		$295.08	$605.66	$1,312.51
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $202.87 / $372.86 / $728.76	Facility		$202.87	$372.86	$728.76
Medica Facility/Professional Facility Modifier Low / Median / High Price $202.87 / $534.48 / $5,801.00	Facility		$202.87	$534.48	$5,801.00
Medica Facility/Professional Professional Modifier Low / Median / High Price $417.16 / $1,231.97 / $2,530.65	Professional		$417.16	$1,231.97	$2,530.65
Molina Facility/Professional Professional Modifier Low / Median / High Price $85.00 / $522.38 / $915.43	Professional		$85.00	$522.38	$915.43
Prevea360 Facility/Professional Facility Modifier Low / Median / High Price $191.18 / $355.60 / $728.76	Facility		$191.18	$355.60	$728.76
Quartz Facility/Professional Professional Modifier Low / Median / High Price $393.10 / $713.70 / $1,298.17	Professional		$393.10	$713.70	$1,298.17
Quartz Facility/Professional Facility Modifier Low / Median / High Price $1,414.98 / $1,414.98 / $1,414.98	Facility		$1,414.98	$1,414.98	$1,414.98
Quartz Facility/Professional Facility Modifier 52 Low / Median / High Price $623.66 / $623.66 / $623.66	Facility	52	$623.66	$623.66	$623.66
Quartz Facility/Professional Professional Modifier Low / Median / High Price $266.63 / $1,440.00 / $2,765.52	Professional		$266.63	$1,440.00	$2,765.52
Security Health Facility/Professional Professional Modifier Low / Median / High Price $596.86 / $1,040.20 / $2,254.14	Professional		$596.86	$1,040.20	$2,254.14
United Facility/Professional Facility Modifier Low / Median / High Price $2,960.00 / $4,155.00 / $5,865.00	Facility		$2,960.00	$4,155.00	$5,865.00
United Facility/Professional Professional Modifier Low / Median / High Price $417.16 / $1,139.72 / $1,626.48	Professional		$417.16	$1,139.72	$1,626.48