Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $396.54 / $1,141.21 / $13,255.10	Facility		$396.54	$1,141.21	$13,255.10
Aetna Facility/Professional Facility Modifier 50 Low / Median / High Price $3,715.67 / $3,715.67 / $3,715.67	Facility	50	$3,715.67	$3,715.67	$3,715.67
Aetna Facility/Professional Professional Modifier Low / Median / High Price $365.55 / $616.97 / $1,732.08	Professional		$365.55	$616.97	$1,732.08
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $5,060.00 / $7,344.00 / $10,517.23	Facility		$5,060.00	$7,344.00	$10,517.23
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $556.32 / $1,086.53 / $3,184.32	Professional		$556.32	$1,086.53	$3,184.32
Anthem BCBS Facility/Professional Professional Modifier 50 Low / Median / High Price $784.77 / $1,657.54 / $4,776.47	Professional	50	$784.77	$1,657.54	$4,776.47
Cigna Facility/Professional Facility Modifier Low / Median / High Price $1,262.47 / $1,475.30 / $2,379.60	Facility		$1,262.47	$1,475.30	$2,379.60
Cigna Facility/Professional Professional Modifier Low / Median / High Price $642.12 / $1,098.33 / $1,975.71	Professional		$642.12	$1,098.33	$1,975.71
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $341.51 / $611.87 / $959.80	Facility		$341.51	$611.87	$959.80
Medica Facility/Professional Facility Modifier Low / Median / High Price $431.94 / $1,023.69 / $11,598.00	Facility		$431.94	$1,023.69	$11,598.00
Medica Facility/Professional Facility Modifier 50 Low / Median / High Price $5,758.65 / $5,758.65 / $5,758.65	Facility	50	$5,758.65	$5,758.65	$5,758.65
Medica Facility/Professional Professional Modifier Low / Median / High Price $603.87 / $1,746.26 / $4,116.10	Professional		$603.87	$1,746.26	$4,116.10
Molina Facility/Professional Professional Modifier Low / Median / High Price $58.40 / $376.09 / $1,056.47	Professional		$58.40	$376.09	$1,056.47
Prevea360 Facility/Professional Facility Modifier Low / Median / High Price $341.51 / $611.87 / $959.80	Facility		$341.51	$611.87	$959.80
Quartz Facility/Professional Professional Modifier Low / Median / High Price $749.56 / $1,122.66 / $1,723.79	Professional		$749.56	$1,122.66	$1,723.79
Quartz Facility/Professional Facility Modifier Low / Median / High Price $1,505.52 / $1,505.52 / $1,505.52	Facility		$1,505.52	$1,505.52	$1,505.52
Quartz Facility/Professional Professional Modifier Low / Median / High Price $601.54 / $2,027.93 / $4,387.22	Professional		$601.54	$2,027.93	$4,387.22
Security Health Facility/Professional Professional Modifier Low / Median / High Price $2,165.79 / $2,841.98 / $3,785.92	Professional		$2,165.79	$2,841.98	$3,785.92
United Facility/Professional Facility Modifier Low / Median / High Price $6,241.00 / $9,837.00 / $12,062.00	Facility		$6,241.00	$9,837.00	$12,062.00
United Facility/Professional Professional Modifier Low / Median / High Price $588.40 / $1,589.63 / $2,675.47	Professional		$588.40	$1,589.63	$2,675.47