Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $217.82 / $1,256.15 / $14,482.00	Facility		$217.82	$1,256.15	$14,482.00
Aetna Facility/Professional Facility Modifier 52 Low / Median / High Price $108.91 / $354.11 / $1,119.36	Facility	52	$108.91	$354.11	$1,119.36
Aetna Facility/Professional Professional Modifier Low / Median / High Price $195.19 / $401.17 / $1,083.58	Professional		$195.19	$401.17	$1,083.58
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 $288.64 / $893.03 / $3,224.63	Professional		$288.64	$893.03	$3,224.63
CareSource Facility/Professional Facility Modifier Low / Median / High Price $186.65 / $260.58 / $372.26	Facility		$186.65	$260.58	$372.26
CareSource Facility/Professional Professional Modifier Low / Median / High Price $1,225.02 / $1,225.02 / $1,225.02	Professional		$1,225.02	$1,225.02	$1,225.02
Cigna Facility/Professional Facility Modifier Low / Median / High Price $1,690.50 / $1,975.48 / $3,030.44	Facility		$1,690.50	$1,975.48	$3,030.44
Cigna Facility/Professional Facility Modifier 52 Low / Median / High Price $269.18 / $269.18 / $269.18	Facility	52	$269.18	$269.18	$269.18
Cigna Facility/Professional Professional Modifier Low / Median / High Price $319.16 / $811.58 / $2,602.39	Professional		$319.16	$811.58	$2,602.39
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $200.19 / $569.58 / $1,200.32	Facility		$200.19	$569.58	$1,200.32
Medica Facility/Professional Facility Modifier Low / Median / High Price $203.20 / $617.23 / $3,242.00	Facility		$203.20	$617.23	$3,242.00
Medica Facility/Professional Facility Modifier 52 Low / Median / High Price $718.14 / $718.14 / $718.14	Facility	52	$718.14	$718.14	$718.14
Medica Facility/Professional Professional Modifier Low / Median / High Price $382.40 / $2,008.32 / $4,612.72	Professional		$382.40	$2,008.32	$4,612.72
Molina Facility/Professional Professional Modifier Low / Median / High Price $85.00 / $828.41 / $1,421.46	Professional		$85.00	$828.41	$1,421.46
Prevea360 Facility/Professional Facility Modifier Low / Median / High Price $200.19 / $569.58 / $1,200.32	Facility		$200.19	$569.58	$1,200.32
Quartz Facility/Professional Professional Modifier Low / Median / High Price $442.85 / $919.68 / $2,061.11	Professional		$442.85	$919.68	$2,061.11
Quartz Facility/Professional Facility Modifier Low / Median / High Price $336.48 / $1,384.26 / $4,901.45	Facility		$336.48	$1,384.26	$4,901.45
Quartz Facility/Professional Facility Modifier 52 Low / Median / High Price $269.18 / $718.14 / $718.14	Facility	52	$269.18	$718.14	$718.14
Quartz Facility/Professional Professional Modifier Low / Median / High Price $380.08 / $2,335.29 / $4,612.72	Professional		$380.08	$2,335.29	$4,612.72
Security Health Facility/Professional Professional Modifier Low / Median / High Price $894.86 / $1,033.03 / $3,177.56	Professional		$894.86	$1,033.03	$3,177.56
United Facility/Professional Facility Modifier Low / Median / High Price $2,883.00 / $3,242.00 / $6,438.00	Facility		$2,883.00	$3,242.00	$6,438.00
United Facility/Professional Professional Modifier Low / Median / High Price $392.85 / $1,243.61 / $2,878.25	Professional		$392.85	$1,243.61	$2,878.25