Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $1,179.06 / $4,914.63 / $9,206.04	Facility		$1,179.06	$4,914.63	$9,206.04
Aetna Facility/Professional Facility Modifier 53 Low / Median / High Price $81.84 / $235.81 / $682.19	Facility	53	$81.84	$235.81	$682.19
Aetna Facility/Professional Professional Modifier Low / Median / High Price $320.72 / $1,114.82 / $4,945.03	Professional		$320.72	$1,114.82	$4,945.03
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $5,060.00 / $8,139.00 / $11,136.00	Facility		$5,060.00	$8,139.00	$11,136.00
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $610.73 / $1,577.08 / $5,106.05	Professional		$610.73	$1,577.08	$5,106.05
CareSource Facility/Professional Facility Modifier Low / Median / High Price $310.26 / $471.35 / $471.35	Facility		$310.26	$471.35	$471.35
CareSource Facility/Professional Professional Modifier Low / Median / High Price $1,223.33 / $1,680.05 / $1,890.90	Professional		$1,223.33	$1,680.05	$1,890.90
Cigna Facility/Professional Facility Modifier Low / Median / High Price $2,579.01 / $3,013.77 / $4,861.10	Facility		$2,579.01	$3,013.77	$4,861.10
Cigna Facility/Professional Professional Modifier Low / Median / High Price $606.45 / $1,335.15 / $3,656.58	Professional		$606.45	$1,335.15	$3,656.58
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $323.43 / $705.56 / $2,015.88	Facility		$323.43	$705.56	$2,015.88
Medica Facility/Professional Facility Modifier Low / Median / High Price $361.24 / $3,855.88 / $11,100.00	Facility		$361.24	$3,855.88	$11,100.00
Medica Facility/Professional Professional Modifier Low / Median / High Price $1,206.23 / $3,622.55 / $6,120.14	Professional		$1,206.23	$3,622.55	$6,120.14
Molina Facility/Professional Professional Modifier Low / Median / High Price $85.00 / $759.56 / $2,006.78	Professional		$85.00	$759.56	$2,006.78
Prevea360 Facility/Professional Facility Modifier Low / Median / High Price $323.43 / $705.56 / $2,015.88	Facility		$323.43	$705.56	$2,015.88
Quartz Facility/Professional Professional Modifier Low / Median / High Price $757.68 / $1,444.33 / $3,159.24	Professional		$757.68	$1,444.33	$3,159.24
Quartz Facility/Professional Facility Modifier Low / Median / High Price $1,904.90 / $1,904.90 / $1,904.90	Facility		$1,904.90	$1,904.90	$1,904.90
Quartz Facility/Professional Facility Modifier 53 Low / Median / High Price $297.92 / $297.92 / $297.92	Facility	53	$297.92	$297.92	$297.92
Quartz Facility/Professional Facility Modifier AS Low / Median / High Price $148.96 / $148.96 / $148.96	Facility	AS	$148.96	$148.96	$148.96
Quartz Facility/Professional Professional Modifier Low / Median / High Price $619.63 / $4,067.24 / $7,664.36	Professional		$619.63	$4,067.24	$7,664.36
Security Health Facility/Professional Professional Modifier Low / Median / High Price $1,682.87 / $2,230.94 / $6,703.66	Professional		$1,682.87	$2,230.94	$6,703.66
United Facility/Professional Facility Modifier Low / Median / High Price $6,295.00 / $9,882.00 / $12,631.00	Facility		$6,295.00	$9,882.00	$12,631.00
United Facility/Professional Professional Modifier Low / Median / High Price $1,195.84 / $3,260.51 / $5,134.60	Professional		$1,195.84	$3,260.51	$5,134.60