Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $182.82 / $1,702.71 / $4,798.53	Facility		$182.82	$1,702.71	$4,798.53
Aetna Facility/Professional Facility Modifier 53 Low / Median / High Price $36.56 / $109.65 / $606.91	Facility	53	$36.56	$109.65	$606.91
Aetna Facility/Professional Professional Modifier Low / Median / High Price $148.71 / $548.25 / $1,691.50	Professional		$148.71	$548.25	$1,691.50
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 $211.86 / $941.34 / $4,583.88	Professional		$211.86	$941.34	$4,583.88
CareSource Facility/Professional Facility Modifier Low / Median / High Price $142.06 / $215.10 / $215.10	Facility		$142.06	$215.10	$215.10
CareSource Facility/Professional Professional Modifier Low / Median / High Price $807.91 / $1,445.89 / $1,627.37	Professional		$807.91	$1,445.89	$1,627.37
Cigna Facility/Professional Facility Modifier Low / Median / High Price $2,297.86 / $2,685.23 / $4,331.18	Facility		$2,297.86	$2,685.23	$4,331.18
Cigna Facility/Professional Professional Modifier Low / Median / High Price $279.70 / $698.04 / $2,978.48	Professional		$279.70	$698.04	$2,978.48
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $164.06 / $297.99 / $1,364.85	Facility		$164.06	$297.99	$1,364.85
Medica Facility/Professional Facility Modifier Low / Median / High Price $175.00 / $1,627.03 / $5,801.00	Facility		$175.00	$1,627.03	$5,801.00
Medica Facility/Professional Professional Modifier Low / Median / High Price $1,074.64 / $2,178.17 / $5,643.81	Professional		$1,074.64	$2,178.17	$5,643.81
Molina Facility/Professional Professional Modifier Low / Median / High Price $85.00 / $792.61 / $1,902.56	Professional		$85.00	$792.61	$1,902.56
Prevea360 Facility/Professional Facility Modifier Low / Median / High Price $164.06 / $297.99 / $1,364.85	Facility		$164.06	$297.99	$1,364.85
Quartz Facility/Professional Professional Modifier Low / Median / High Price $335.66 / $906.50 / $2,782.22	Professional		$335.66	$906.50	$2,782.22
Quartz Facility/Professional Facility Modifier Low / Median / High Price $1,222.61 / $1,222.61 / $1,222.61	Facility		$1,222.61	$1,222.61	$1,222.61
Quartz Facility/Professional Facility Modifier 53 Low / Median / High Price $135.34 / $135.34 / $135.34	Facility	53	$135.34	$135.34	$135.34
Quartz Facility/Professional Professional Modifier Low / Median / High Price $265.93 / $1,123.83 / $6,211.20	Professional		$265.93	$1,123.83	$6,211.20
Security Health Facility/Professional Professional Modifier Low / Median / High Price $373.89 / $894.92 / $5,115.24	Professional		$373.89	$894.92	$5,115.24
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 $1,020.61 / $2,958.34 / $4,327.32	Professional		$1,020.61	$2,958.34	$4,327.32