Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $189.62 / $1,188.99 / $14,482.00	Facility		$189.62	$1,188.99	$14,482.00
Aetna Facility/Professional Facility Modifier 52 Low / Median / High Price $94.81 / $314.73 / $1,059.52	Facility	52	$94.81	$314.73	$1,059.52
Aetna Facility/Professional Professional Modifier Low / Median / High Price $168.25 / $338.39 / $996.87	Professional		$168.25	$338.39	$996.87
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $1,905.00 / $3,193.00 / $5,962.00	Facility		$1,905.00	$3,193.00	$5,962.00
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $251.20 / $782.99 / $3,055.90	Professional		$251.20	$782.99	$3,055.90
Cigna Facility/Professional Facility Modifier Low / Median / High Price $1,601.29 / $1,871.23 / $2,870.52	Facility		$1,601.29	$1,871.23	$2,870.52
Cigna Facility/Professional Facility Modifier 52 Low / Median / High Price $237.66 / $237.66 / $237.66	Facility	52	$237.66	$237.66	$237.66
Cigna Facility/Professional Professional Modifier Low / Median / High Price $274.70 / $706.31 / $2,348.16	Professional		$274.70	$706.31	$2,348.16
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $175.68 / $503.88 / $1,019.04	Facility		$175.68	$503.88	$1,019.04
Medica Facility/Professional Facility Modifier Low / Median / High Price $175.68 / $546.00 / $3,242.00	Facility		$175.68	$546.00	$3,242.00
Medica Facility/Professional Facility Modifier 52 Low / Median / High Price $634.61 / $634.61 / $634.61	Facility	52	$634.61	$634.61	$634.61
Medica Facility/Professional Professional Modifier Low / Median / High Price $258.48 / $1,977.15 / $4,363.52	Professional		$258.48	$1,977.15	$4,363.52
Molina Facility/Professional Professional Modifier Low / Median / High Price $85.00 / $633.99 / $1,344.92	Professional		$85.00	$633.99	$1,344.92
Prevea360 Facility/Professional Facility Modifier Low / Median / High Price $177.47 / $503.88 / $1,019.04	Facility		$177.47	$503.88	$1,019.04
Quartz Facility/Professional Professional Modifier Low / Median / High Price $391.32 / $797.40 / $1,957.77	Professional		$391.32	$797.40	$1,957.77
Quartz Facility/Professional Facility Modifier Low / Median / High Price $297.07 / $1,213.14 / $4,901.45	Facility		$297.07	$1,213.14	$4,901.45
Quartz Facility/Professional Facility Modifier 52 Low / Median / High Price $237.66 / $634.61 / $634.61	Facility	52	$237.66	$634.61	$634.61
Quartz Facility/Professional Professional Modifier Low / Median / High Price $330.78 / $2,221.92 / $4,363.52	Professional		$330.78	$2,221.92	$4,363.52
Security Health Facility/Professional Professional Modifier Low / Median / High Price $688.36 / $862.41 / $3,006.28	Professional		$688.36	$862.41	$3,006.28
United Facility/Professional Facility Modifier Low / Median / High Price $2,781.00 / $3,628.00 / $5,471.00	Facility		$2,781.00	$3,628.00	$5,471.00
United Facility/Professional Professional Modifier Low / Median / High Price $271.19 / $1,251.43 / $2,578.58	Professional		$271.19	$1,251.43	$2,578.58