Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $627.48 / $3,391.20 / $14,617.11	Facility		$627.48	$3,391.20	$14,617.11
Aetna Facility/Professional Facility Modifier 50 Low / Median / High Price $10,641.80 / $10,641.80 / $10,641.80	Facility	50	$10,641.80	$10,641.80	$10,641.80
Aetna Facility/Professional Professional Modifier Low / Median / High Price $326.87 / $1,497.07 / $2,966.71	Professional		$326.87	$1,497.07	$2,966.71
Aetna Facility/Professional Professional Modifier 50 Low / Median / High Price $608.98 / $1,086.47 / $2,546.46	Professional	50	$608.98	$1,086.47	$2,546.46
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $6,538.00 / $9,695.00 / $15,287.53	Facility		$6,538.00	$9,695.00	$15,287.53
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $443.02 / $1,928.88 / $7,685.61	Professional		$443.02	$1,928.88	$7,685.61
Anthem BCBS Facility/Professional Professional Modifier 50 Low / Median / High Price $731.07 / $2,893.32 / $11,850.12	Professional	50	$731.07	$2,893.32	$11,850.12
Cigna Facility/Professional Facility Modifier Low / Median / High Price $4,464.14 / $5,216.71 / $6,933.44	Facility		$4,464.14	$5,216.71	$6,933.44
Cigna Facility/Professional Professional Modifier Low / Median / High Price $485.69 / $1,761.68 / $5,849.05	Professional		$485.69	$1,761.68	$5,849.05
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $359.58 / $1,507.20 / $2,960.12	Facility		$359.58	$1,507.20	$2,960.12
Medica Facility/Professional Facility Modifier Low / Median / High Price $359.62 / $1,942.33 / $13,822.07	Facility		$359.62	$1,942.33	$13,822.07
Medica Facility/Professional Professional Modifier Low / Median / High Price $1,811.72 / $5,790.58 / $12,114.16	Professional		$1,811.72	$5,790.58	$12,114.16
Medica Facility/Professional Professional Modifier 50 Low / Median / High Price $596.20 / $596.20 / $1,085.08	Professional	50	$596.20	$596.20	$1,085.08
Molina Facility/Professional Professional Modifier Low / Median / High Price $942.25 / $1,566.02 / $4,041.67	Professional		$942.25	$1,566.02	$4,041.67
Prevea360 Facility/Professional Facility Modifier Low / Median / High Price $359.58 / $1,507.20 / $2,960.12	Facility		$359.58	$1,507.20	$2,960.12
Quartz Facility/Professional Professional Modifier Low / Median / High Price $750.32 / $1,780.87 / $5,622.36	Professional		$750.32	$1,780.87	$5,622.36
Quartz Facility/Professional Facility Modifier Low / Median / High Price $786.44 / $2,706.05 / $2,706.05	Facility		$786.44	$2,706.05	$2,706.05
Quartz Facility/Professional Professional Modifier Low / Median / High Price $647.55 / $6,277.35 / $12,114.16	Professional		$647.55	$6,277.35	$12,114.16
Security Health Facility/Professional Professional Modifier Low / Median / High Price $1,521.95 / $6,184.11 / $11,533.94	Professional		$1,521.95	$6,184.11	$11,533.94
United Facility/Professional Facility Modifier Low / Median / High Price $8,627.00 / $12,373.00 / $15,090.00	Facility		$8,627.00	$12,373.00	$15,090.00
United Facility/Professional Professional Modifier Low / Median / High Price $1,788.31 / $4,817.43 / $8,175.05	Professional		$1,788.31	$4,817.43	$8,175.05