Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $428.24 / $4,132.91 / $14,482.00	Facility		$428.24	$4,132.91	$14,482.00
Aetna Facility/Professional Facility Modifier 50 Low / Median / High Price $9,163.20 / $20,212.56 / $20,438.16	Facility	50	$9,163.20	$20,212.56	$20,438.16
Aetna Facility/Professional Professional Modifier 50 Low / Median / High Price $691.45 / $2,672.91 / $5,737.50	Professional	50	$691.45	$2,672.91	$5,737.50
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $6,538.00 / $10,914.00 / $15,579.70	Facility		$6,538.00	$10,914.00	$15,579.70
Anthem BCBS Facility/Professional Professional Modifier 50 Low / Median / High Price $827.15 / $3,456.09 / $14,774.04	Professional	50	$827.15	$3,456.09	$14,774.04
CareSource Facility/Professional Facility Modifier Low / Median / High Price $317.74 / $456.21 / $562.20	Facility		$317.74	$456.21	$562.20
Cigna Facility/Professional Facility Modifier Low / Median / High Price $5,521.16 / $6,451.91 / $8,575.12	Facility		$5,521.16	$6,451.91	$8,575.12
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $402.79 / $1,723.64 / $3,773.16	Facility		$402.79	$1,723.64	$3,773.16
Medica Facility/Professional Facility Modifier Low / Median / High Price $406.01 / $2,411.98 / $13,822.07	Facility		$406.01	$2,411.98	$13,822.07
Medica Facility/Professional Facility Modifier 50 Low / Median / High Price $13,604.85 / $13,604.85 / $13,604.85	Facility	50	$13,604.85	$13,604.85	$13,604.85
Medica Facility/Professional Professional Modifier 50 Low / Median / High Price $666.70 / $1,976.33 / $12,486.00	Professional	50	$666.70	$1,976.33	$12,486.00
Prevea360 Facility/Professional Facility Modifier Low / Median / High Price $402.79 / $1,723.64 / $3,773.16	Facility		$402.79	$1,723.64	$3,773.16
Quartz Facility/Professional Professional Modifier Low / Median / High Price $842.68 / $2,169.71 / $6,849.94	Professional		$842.68	$2,169.71	$6,849.94
Quartz Facility/Professional Facility Modifier Low / Median / High Price $878.04 / $3,754.30 / $3,754.30	Facility		$878.04	$3,754.30	$3,754.30
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