Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $462.96 / $3,734.63 / $14,482.00	Facility		$462.96	$3,734.63	$14,482.00
Aetna Facility/Professional Facility Modifier 50 Low / Median / High Price $3,715.67 / $8,891.24 / $21,042.18	Facility	50	$3,715.67	$8,891.24	$21,042.18
Aetna Facility/Professional Professional Modifier Low / Median / High Price $321.50 / $1,250.00 / $7,061.92	Professional		$321.50	$1,250.00	$7,061.92
Aetna Facility/Professional Professional Modifier 50 Low / Median / High Price $1,102.85 / $1,102.85 / $8,764.00	Professional	50	$1,102.85	$1,102.85	$8,764.00
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $5,169.00 / $8,408.00 / $12,444.00	Facility		$5,169.00	$8,408.00	$12,444.00
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $350.31 / $1,384.74 / $4,838.10	Professional		$350.31	$1,384.74	$4,838.10
Anthem BCBS Facility/Professional Professional Modifier 50 Low / Median / High Price $525.46 / $2,077.11 / $7,257.15	Professional	50	$525.46	$2,077.11	$7,257.15
CareSource Facility/Professional Facility Modifier Low / Median / High Price $260.25 / $403.05 / $403.05	Facility		$260.25	$403.05	$403.05
CareSource Facility/Professional Professional Modifier Low / Median / High Price $1,341.59 / $2,073.67 / $2,073.67	Professional		$1,341.59	$2,073.67	$2,073.67
Cigna Facility/Professional Facility Modifier Low / Median / High Price $2,842.13 / $3,321.26 / $5,357.07	Facility		$2,842.13	$3,321.26	$5,357.07
Cigna Facility/Professional Professional Modifier Low / Median / High Price $487.57 / $1,007.33 / $4,352.28	Professional		$487.57	$1,007.33	$4,352.28
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $284.02 / $580.61 / $2,002.36	Facility		$284.02	$580.61	$2,002.36
Medica Facility/Professional Facility Modifier Low / Median / High Price $369.85 / $2,972.65 / $11,598.00	Facility		$369.85	$2,972.65	$11,598.00
Medica Facility/Professional Professional Modifier Low / Median / High Price $1,582.63 / $4,602.82 / $9,157.00	Professional		$1,582.63	$4,602.82	$9,157.00
Molina Facility/Professional Professional Modifier Low / Median / High Price $85.00 / $1,030.83 / $2,518.88	Professional		$85.00	$1,030.83	$2,518.88
Prevea360 Facility/Professional Facility Modifier Low / Median / High Price $284.02 / $580.61 / $2,002.36	Facility		$284.02	$580.61	$2,002.36
Quartz Facility/Professional Professional Modifier Low / Median / High Price $628.32 / $1,176.75 / $3,474.94	Professional		$628.32	$1,176.75	$3,474.94
Quartz Facility/Professional Facility Modifier Low / Median / High Price $1,881.78 / $1,881.78 / $1,881.78	Facility		$1,881.78	$1,881.78	$1,881.78
Quartz Facility/Professional Professional Modifier Low / Median / High Price $501.10 / $4,510.76 / $12,119.05	Professional		$501.10	$4,510.76	$12,119.05
Security Health Facility/Professional Professional Modifier Low / Median / High Price $1,374.42 / $2,453.44 / $8,173.70	Professional		$1,374.42	$2,453.44	$8,173.70
United Facility/Professional Facility Modifier Low / Median / High Price $6,241.00 / $9,882.00 / $12,631.00	Facility		$6,241.00	$9,882.00	$12,631.00
United Facility/Professional Professional Modifier Low / Median / High Price $1,284.69 / $3,996.15 / $6,749.82	Professional		$1,284.69	$3,996.15	$6,749.82