Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $335.39 / $2,660.35 / $6,780.86	Facility		$335.39	$2,660.35	$6,780.86
Aetna Facility/Professional Facility Modifier 52 Low / Median / High Price $90.19 / $232.57 / $747.61	Facility	52	$90.19	$232.57	$747.61
Aetna Facility/Professional Professional Modifier Low / Median / High Price $159.76 / $366.40 / $1,495.21	Professional		$159.76	$366.40	$1,495.21
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 $221.98 / $635.16 / $2,102.10	Professional		$221.98	$635.16	$2,102.10
CareSource Facility/Professional Facility Modifier Low / Median / High Price $154.78 / $193.67 / $233.49	Facility		$154.78	$193.67	$233.49
CareSource Facility/Professional Professional Modifier Low / Median / High Price $367.83 / $463.67 / $828.31	Professional		$367.83	$463.67	$828.31
Cigna Facility/Professional Facility Modifier Low / Median / High Price $1,113.78 / $1,301.55 / $1,996.60	Facility		$1,113.78	$1,301.55	$1,996.60
Cigna Facility/Professional Facility Modifier 52 Low / Median / High Price $223.11 / $223.11 / $223.11	Facility	52	$223.11	$223.11	$223.11
Cigna Facility/Professional Professional Modifier Low / Median / High Price $259.33 / $654.48 / $1,720.09	Professional		$259.33	$654.48	$1,720.09
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $165.53 / $393.22 / $709.49	Facility		$165.53	$393.22	$709.49
Medica Facility/Professional Facility Modifier Low / Median / High Price $165.53 / $412.52 / $2,855.25	Facility		$165.53	$412.52	$2,855.25
Medica Facility/Professional Facility Modifier 52 Low / Median / High Price $595.82 / $595.82 / $595.82	Facility	52	$595.82	$595.82	$595.82
Medica Facility/Professional Professional Modifier Low / Median / High Price $258.10 / $1,238.35 / $3,058.16	Professional		$258.10	$1,238.35	$3,058.16
Molina Facility/Professional Professional Modifier Low / Median / High Price $85.00 / $556.52 / $946.60	Professional		$85.00	$556.52	$946.60
Prevea360 Facility/Professional Facility Modifier Low / Median / High Price $166.40 / $393.22 / $709.49	Facility		$166.40	$393.22	$709.49
Quartz Facility/Professional Professional Modifier Low / Median / High Price $367.43 / $760.16 / $1,379.75	Professional		$367.43	$760.16	$1,379.75
Quartz Facility/Professional Facility Modifier Low / Median / High Price $278.89 / $1,150.80 / $2,855.25	Facility		$278.89	$1,150.80	$2,855.25
Quartz Facility/Professional Facility Modifier 52 Low / Median / High Price $223.11 / $595.82 / $595.82	Facility	52	$223.11	$595.82	$595.82
Quartz Facility/Professional Professional Modifier Low / Median / High Price $315.33 / $1,557.16 / $3,058.16	Professional		$315.33	$1,557.16	$3,058.16
Security Health Facility/Professional Professional Modifier Low / Median / High Price $671.08 / $822.17 / $2,100.23	Professional		$671.08	$822.17	$2,100.23
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 $261.48 / $681.23 / $1,708.94	Professional		$261.48	$681.23	$1,708.94