Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $920.69 / $3,832.25 / $7,136.64	Facility		$920.69	$3,832.25	$7,136.64
Aetna Facility/Professional Facility Modifier 52 Low / Median / High Price $75.18 / $212.28 / $680.10	Facility	52	$75.18	$212.28	$680.10
Aetna Facility/Professional Facility Modifier 53 Low / Median / High Price $30.07 / $84.91 / $272.04	Facility	53	$30.07	$84.91	$272.04
Aetna Facility/Professional Professional Modifier Low / Median / High Price $101.94 / $386.16 / $2,607.30	Professional		$101.94	$386.16	$2,607.30
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $1,314.00 / $2,550.00 / $4,471.00	Facility		$1,314.00	$2,550.00	$4,471.00
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $201.15 / $562.44 / $1,924.33	Professional		$201.15	$562.44	$1,924.33
CareSource Facility/Professional Facility Modifier Low / Median / High Price $128.84 / $161.47 / $194.12	Facility		$128.84	$161.47	$194.12
CareSource Facility/Professional Professional Modifier Low / Median / High Price $333.35 / $419.94 / $748.68	Professional		$333.35	$419.94	$748.68
Cigna Facility/Professional Facility Modifier Low / Median / High Price $1,016.46 / $1,187.82 / $1,822.14	Facility		$1,016.46	$1,187.82	$1,822.14
Cigna Facility/Professional Facility Modifier 52 Low / Median / High Price $185.70 / $185.70 / $185.70	Facility	52	$185.70	$185.70	$185.70
Cigna Facility/Professional Facility Modifier 53 Low / Median / High Price $46.42 / $46.42 / $46.42	Facility	53	$46.42	$46.42	$46.42
Cigna Facility/Professional Professional Modifier Low / Median / High Price $218.66 / $562.08 / $1,568.20	Professional		$218.66	$562.08	$1,568.20
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $142.84 / $349.00 / $683.78	Facility		$142.84	$349.00	$683.78
Medica Facility/Professional Facility Modifier Low / Median / High Price $150.35 / $453.64 / $3,115.20	Facility		$150.35	$453.64	$3,115.20
Medica Facility/Professional Facility Modifier 52 Low / Median / High Price $496.53 / $496.53 / $496.53	Facility	52	$496.53	$496.53	$496.53
Medica Facility/Professional Facility Modifier 53 Low / Median / High Price $124.13 / $124.13 / $124.13	Facility	53	$124.13	$124.13	$124.13
Medica Facility/Professional Professional Modifier Low / Median / High Price $339.20 / $1,146.60 / $2,784.32	Professional		$339.20	$1,146.60	$2,784.32
Molina Facility/Professional Professional Modifier Low / Median / High Price $85.00 / $489.65 / $838.27	Professional		$85.00	$489.65	$838.27
Prevea360 Facility/Professional Facility Modifier Low / Median / High Price $144.25 / $343.17 / $683.78	Facility		$144.25	$343.17	$683.78
Quartz Facility/Professional Professional Modifier Low / Median / High Price $306.19 / $632.02 / $1,253.70	Professional		$306.19	$632.02	$1,253.70
Quartz Facility/Professional Facility Modifier Low / Median / High Price $232.12 / $960.78 / $2,880.50	Facility		$232.12	$960.78	$2,880.50
Quartz Facility/Professional Facility Modifier 52 Low / Median / High Price $185.70 / $496.53 / $496.53	Facility	52	$185.70	$496.53	$496.53
Quartz Facility/Professional Facility Modifier 53 Low / Median / High Price $46.42 / $124.13 / $124.13	Facility	53	$46.42	$124.13	$124.13
Quartz Facility/Professional Professional Modifier Low / Median / High Price $272.95 / $1,415.95 / $2,784.32	Professional		$272.95	$1,415.95	$2,784.32
Security Health Facility/Professional Professional Modifier Low / Median / High Price $577.12 / $1,253.46 / $1,302.33	Professional		$577.12	$1,253.46	$1,302.33
United Facility/Professional Facility Modifier Low / Median / High Price $2,976.00 / $3,827.00 / $5,471.00	Facility		$2,976.00	$3,827.00	$5,471.00
United Facility/Professional Professional Modifier Low / Median / High Price $357.11 / $750.96 / $1,634.11	Professional		$357.11	$750.96	$1,634.11