Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $580.46 / $1,829.29 / $8,766.42	Facility		$580.46	$1,829.29	$8,766.42
Aetna Facility/Professional Facility Modifier 50 Low / Median / High Price $3,565.90 / $3,565.90 / $3,565.90	Facility	50	$3,565.90	$3,565.90	$3,565.90
Aetna Facility/Professional Professional Modifier Low / Median / High Price $305.29 / $900.16 / $2,968.68	Professional		$305.29	$900.16	$2,968.68
Aetna Facility/Professional Professional Modifier 50 Low / Median / High Price $2,039.03 / $2,332.66 / $6,015.33	Professional	50	$2,039.03	$2,332.66	$6,015.33
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $1,139.00 / $1,183.00 / $1,530.00	Facility		$1,139.00	$1,183.00	$1,530.00
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $446.48 / $1,763.29 / $7,140.91	Professional		$446.48	$1,763.29	$7,140.91
Anthem BCBS Facility/Professional Professional Modifier 50 Low / Median / High Price $705.46 / $2,644.93 / $10,885.03	Professional	50	$705.46	$2,644.93	$10,885.03
CareSource Facility/Professional Facility Modifier Low / Median / High Price $261.01 / $361.35 / $451.13	Facility		$261.01	$361.35	$451.13
CareSource Facility/Professional Professional Modifier Low / Median / High Price $1,269.24 / $1,571.44 / $3,203.32	Professional		$1,269.24	$1,571.44	$3,203.32
Cigna Facility/Professional Facility Modifier Low / Median / High Price $3,776.59 / $4,413.25 / $5,865.57	Facility		$3,776.59	$4,413.25	$5,865.57
Cigna Facility/Professional Professional Modifier Low / Median / High Price $433.54 / $1,159.61 / $4,955.41	Professional		$433.54	$1,159.61	$4,955.41
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $345.21 / $862.94 / $2,829.67	Facility		$345.21	$862.94	$2,829.67
Medica Facility/Professional Facility Modifier Low / Median / High Price $350.40 / $1,368.00 / $2,829.67	Facility		$350.40	$1,368.00	$2,829.67
Medica Facility/Professional Facility Modifier 50 Low / Median / High Price $7,894.35 / $7,894.35 / $7,894.35	Facility	50	$7,894.35	$7,894.35	$7,894.35
Medica Facility/Professional Professional Modifier Low / Median / High Price $1,560.15 / $5,237.85 / $11,617.10	Professional		$1,560.15	$5,237.85	$11,617.10
Molina Facility/Professional Professional Modifier Low / Median / High Price $757.65 / $1,244.91 / $3,206.43	Professional		$757.65	$1,244.91	$3,206.43
Prevea360 Facility/Professional Facility Modifier Low / Median / High Price $349.72 / $862.94 / $2,829.67	Facility		$349.72	$862.94	$2,829.67
Quartz Facility/Professional Professional Modifier Low / Median / High Price $664.31 / $1,456.43 / $4,598.04	Professional		$664.31	$1,456.43	$4,598.04
Quartz Facility/Professional Facility Modifier Low / Median / High Price $727.50 / $2,500.38 / $8,734.00	Facility		$727.50	$2,500.38	$8,734.00
Quartz Facility/Professional Professional Modifier Low / Median / High Price $652.11 / $5,237.85 / $11,617.10	Professional		$652.11	$5,237.85	$11,617.10
Security Health Facility/Professional Professional Modifier Low / Median / High Price $1,380.05 / $1,765.65 / $7,394.31	Professional		$1,380.05	$1,765.65	$7,394.31
United Facility/Professional Facility Modifier Low / Median / High Price $1,034.00 / $1,533.00 / $2,202.90	Facility		$1,034.00	$1,533.00	$2,202.90
United Facility/Professional Professional Modifier Low / Median / High Price $1,560.15 / $3,919.47 / $6,608.79	Professional		$1,560.15	$3,919.47	$6,608.79