Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $945.30 / $4,064.30 / $6,153.70	Facility		$945.30	$4,064.30	$6,153.70
Aetna Facility/Professional Facility Modifier 52 Low / Median / High Price $83.30 / $614.20 / $1,895.35	Facility	52	$83.30	$614.20	$1,895.35
Aetna Facility/Professional Facility Modifier 53 Low / Median / High Price $33.32 / $110.42 / $758.14	Facility	53	$33.32	$110.42	$758.14
Aetna Facility/Professional Professional Modifier Low / Median / High Price $150.87 / $566.85 / $1,815.79	Professional		$150.87	$566.85	$1,815.79
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 $220.70 / $1,030.56 / $5,653.29	Professional		$220.70	$1,030.56	$5,653.29
CareSource Facility/Professional Facility Modifier Low / Median / High Price $143.11 / $178.92 / $215.94	Facility		$143.11	$178.92	$215.94
CareSource Facility/Professional Professional Modifier Low / Median / High Price $915.72 / $1,144.65 / $2,020.43	Professional		$915.72	$1,144.65	$2,020.43
Cigna Facility/Professional Facility Modifier Low / Median / High Price $2,931.34 / $3,425.51 / $5,254.81	Facility		$2,931.34	$3,425.51	$5,254.81
Cigna Facility/Professional Facility Modifier 52 Low / Median / High Price $206.22 / $206.22 / $206.22	Facility	52	$206.22	$206.22	$206.22
Cigna Facility/Professional Facility Modifier 53 Low / Median / High Price $51.55 / $51.55 / $51.55	Facility	53	$51.55	$51.55	$51.55
Cigna Facility/Professional Professional Modifier Low / Median / High Price $240.93 / $621.80 / $4,232.13	Professional		$240.93	$621.80	$4,232.13
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $153.06 / $453.57 / $1,770.03	Facility		$153.06	$453.57	$1,770.03
Medica Facility/Professional Facility Modifier Low / Median / High Price $158.69 / $945.31 / $3,242.00	Facility		$158.69	$945.31	$3,242.00
Medica Facility/Professional Facility Modifier 52 Low / Median / High Price $551.04 / $551.04 / $551.04	Facility	52	$551.04	$551.04	$551.04
Medica Facility/Professional Facility Modifier 53 Low / Median / High Price $137.76 / $137.76 / $137.76	Facility	53	$137.76	$137.76	$137.76
Medica Facility/Professional Professional Modifier Low / Median / High Price $239.00 / $2,842.95 / $7,882.64	Professional		$239.00	$2,842.95	$7,882.64
Molina Facility/Professional Professional Modifier Low / Median / High Price $85.00 / $1,164.73 / $2,460.20	Professional		$85.00	$1,164.73	$2,460.20
Prevea360 Facility/Professional Facility Modifier Low / Median / High Price $154.58 / $453.57 / $1,770.03	Facility		$154.58	$453.57	$1,770.03
Quartz Facility/Professional Professional Modifier Low / Median / High Price $339.79 / $1,102.11 / $3,479.48	Professional		$339.79	$1,102.11	$3,479.48
Quartz Facility/Professional Facility Modifier Low / Median / High Price $257.77 / $1,063.56 / $4,901.45	Facility		$257.77	$1,063.56	$4,901.45
Quartz Facility/Professional Facility Modifier 52 Low / Median / High Price $206.22 / $551.04 / $551.04	Facility	52	$206.22	$551.04	$551.04
Quartz Facility/Professional Facility Modifier 53 Low / Median / High Price $51.55 / $137.76 / $137.76	Facility	53	$51.55	$137.76	$137.76
Quartz Facility/Professional Professional Modifier Low / Median / High Price $291.20 / $3,968.70 / $7,882.64	Professional		$291.20	$3,968.70	$7,882.64
Security Health Facility/Professional Professional Modifier Low / Median / High Price $603.97 / $759.27 / $5,464.37	Professional		$603.97	$759.27	$5,464.37
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 $251.52 / $2,097.26 / $4,789.25	Professional		$251.52	$2,097.26	$4,789.25