Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $406.67 / $4,283.93 / $14,764.94	Facility		$406.67	$4,283.93	$14,764.94
Aetna Facility/Professional Facility Modifier 50 Low / Median / High Price $1,558.68 / $1,558.68 / $7,791.12	Facility	50	$1,558.68	$1,558.68	$7,791.12
Aetna Facility/Professional Professional Modifier Low / Median / High Price $364.50 / $625.29 / $2,550.67	Professional		$364.50	$625.29	$2,550.67
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 $412.28 / $1,113.08 / $2,781.36	Professional		$412.28	$1,113.08	$2,781.36
CareSource Facility/Professional Facility Modifier Low / Median / High Price $420.54 / $641.09 / $641.09	Facility		$420.54	$641.09	$641.09
CareSource Facility/Professional Professional Modifier Low / Median / High Price $413.99 / $641.09 / $990.91	Professional		$413.99	$641.09	$990.91
Cigna Facility/Professional Facility Modifier Low / Median / High Price $1,111.98 / $1,299.44 / $2,095.94	Facility		$1,111.98	$1,299.44	$2,095.94
Cigna Facility/Professional Professional Modifier Low / Median / High Price $808.51 / $1,326.02 / $1,783.86	Professional		$808.51	$1,326.02	$1,783.86
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $406.67 / $546.00 / $1,096.44	Facility		$406.67	$546.00	$1,096.44
Medica Facility/Professional Facility Modifier Low / Median / High Price $406.67 / $2,885.71 / $8,783.00	Facility		$406.67	$2,885.71	$8,783.00
Medica Facility/Professional Professional Modifier Low / Median / High Price $492.96 / $1,075.27 / $2,393.82	Professional		$492.96	$1,075.27	$2,393.82
Molina Facility/Professional Professional Modifier Low / Median / High Price $63.30 / $341.57 / $877.22	Professional		$63.30	$341.57	$877.22
Prevea360 Facility/Professional Facility Modifier Low / Median / High Price $406.67 / $546.00 / $1,096.44	Facility		$406.67	$546.00	$1,096.44
Quartz Facility/Professional Professional Modifier Low / Median / High Price $872.95 / $1,343.00 / $1,826.19	Professional		$872.95	$1,343.00	$1,826.19
Quartz Facility/Professional Facility Modifier Low / Median / High Price $8,723.79 / $8,723.79 / $8,723.79	Facility		$8,723.79	$8,723.79	$8,723.79
Quartz Facility/Professional Professional Modifier Low / Median / High Price $825.27 / $2,062.00 / $3,301.00	Professional		$825.27	$2,062.00	$3,301.00
Security Health Facility/Professional Professional Modifier Low / Median / High Price $804.66 / $2,348.40 / $2,348.40	Professional		$804.66	$2,348.40	$2,348.40
United Facility/Professional Facility Modifier Low / Median / High Price $4,614.00 / $6,477.00 / $8,384.00	Facility		$4,614.00	$6,477.00	$8,384.00
United Facility/Professional Professional Modifier Low / Median / High Price $490.55 / $1,075.27 / $1,807.34	Professional		$490.55	$1,075.27	$1,807.34