Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $191.56 / $2,305.85 / $9,176.86	Facility		$191.56	$2,305.85	$9,176.86
Aetna Facility/Professional Facility Modifier 52 Low / Median / High Price $95.78 / $215.18 / $695.64	Facility	52	$95.78	$215.18	$695.64
Aetna Facility/Professional Facility Modifier 53 Low / Median / High Price $38.31 / $86.07 / $278.25	Facility	53	$38.31	$86.07	$278.25
Aetna Facility/Professional Professional Modifier Low / Median / High Price $171.19 / $317.24 / $780.64	Professional		$171.19	$317.24	$780.64
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 $253.78 / $646.96 / $1,949.22	Professional		$253.78	$646.96	$1,949.22
Cigna Facility/Professional Facility Modifier Low / Median / High Price $1,028.18 / $1,201.51 / $1,843.14	Facility		$1,028.18	$1,201.51	$1,843.14
Cigna Facility/Professional Facility Modifier 52 Low / Median / High Price $237.29 / $237.29 / $237.29	Facility	52	$237.29	$237.29	$237.29
Cigna Facility/Professional Facility Modifier 53 Low / Median / High Price $59.32 / $59.32 / $59.32	Facility	53	$59.32	$59.32	$59.32
Cigna Facility/Professional Professional Modifier Low / Median / High Price $274.10 / $628.66 / $1,592.96	Professional		$274.10	$628.66	$1,592.96
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $175.81 / $365.81 / $745.94	Facility		$175.81	$365.81	$745.94
Medica Facility/Professional Facility Modifier Low / Median / High Price $178.11 / $389.81 / $3,173.40	Facility		$178.11	$389.81	$3,173.40
Medica Facility/Professional Facility Modifier 52 Low / Median / High Price $633.38 / $633.38 / $633.38	Facility	52	$633.38	$633.38	$633.38
Medica Facility/Professional Facility Modifier 53 Low / Median / High Price $158.34 / $158.34 / $158.34	Facility	53	$158.34	$158.34	$158.34
Medica Facility/Professional Professional Modifier Low / Median / High Price $273.36 / $1,222.88 / $2,839.20	Professional		$273.36	$1,222.88	$2,839.20
Molina Facility/Professional Professional Modifier Low / Median / High Price $85.00 / $587.80 / $866.94	Professional		$85.00	$587.80	$866.94
Prevea360 Facility/Professional Facility Modifier Low / Median / High Price $178.11 / $366.46 / $745.94	Facility		$178.11	$366.46	$745.94
Quartz Facility/Professional Professional Modifier Low / Median / High Price $390.73 / $736.45 / $1,286.63	Professional		$390.73	$736.45	$1,286.63
Quartz Facility/Professional Facility Modifier Low / Median / High Price $296.61 / $1,222.50 / $2,855.25	Facility		$296.61	$1,222.50	$2,855.25
Quartz Facility/Professional Facility Modifier 52 Low / Median / High Price $237.29 / $633.38 / $633.38	Facility	52	$237.29	$633.38	$633.38
Quartz Facility/Professional Facility Modifier 53 Low / Median / High Price $59.32 / $158.34 / $158.34	Facility	53	$59.32	$158.34	$158.34
Quartz Facility/Professional Professional Modifier Low / Median / High Price $334.56 / $1,629.63 / $2,839.20	Professional		$334.56	$1,629.63	$2,839.20
Security Health Facility/Professional Professional Modifier Low / Median / High Price $697.92 / $872.24 / $1,945.02	Professional		$697.92	$872.24	$1,945.02
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 $277.47 / $718.28 / $1,626.90	Professional		$277.47	$718.28	$1,626.90