Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $90.36 / $1,771.00 / $6,360.20	Facility		$90.36	$1,771.00	$6,360.20
Aetna Facility/Professional Facility Modifier 52 Low / Median / High Price $39.29 / $131.37 / $518.66	Facility	52	$39.29	$131.37	$518.66
Aetna Facility/Professional Facility Modifier 53 Low / Median / High Price $15.72 / $52.55 / $207.46	Facility	53	$15.72	$52.55	$207.46
Aetna Facility/Professional Professional Modifier Low / Median / High Price $67.84 / $172.84 / $747.12	Professional		$67.84	$172.84	$747.12
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $1,139.00 / $2,419.00 / $4,441.52	Facility		$1,139.00	$2,419.00	$4,441.52
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $104.10 / $345.89 / $1,382.10	Professional		$104.10	$345.89	$1,382.10
CareSource Facility/Professional Facility Modifier Low / Median / High Price $67.86 / $84.93 / $102.05	Facility		$67.86	$84.93	$102.05
CareSource Facility/Professional Professional Modifier Low / Median / High Price $251.74 / $316.29 / $561.14	Professional		$251.74	$316.29	$561.14
Cigna Facility/Professional Facility Modifier Low / Median / High Price $780.37 / $911.92 / $1,398.91	Facility		$780.37	$911.92	$1,398.91
Cigna Facility/Professional Facility Modifier 52 Low / Median / High Price $97.57 / $97.57 / $97.57	Facility	52	$97.57	$97.57	$97.57
Cigna Facility/Professional Facility Modifier 53 Low / Median / High Price $24.39 / $24.39 / $24.39	Facility	53	$24.39	$24.39	$24.39
Cigna Facility/Professional Professional Modifier Low / Median / High Price $114.55 / $299.50 / $1,195.71	Professional		$114.55	$299.50	$1,195.71
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $72.18 / $180.55 / $465.62	Facility		$72.18	$180.55	$465.62
Medica Facility/Professional Facility Modifier Low / Median / High Price $73.88 / $230.00 / $2,331.19	Facility		$73.88	$230.00	$2,331.19
Medica Facility/Professional Facility Modifier 52 Low / Median / High Price $262.79 / $262.79 / $262.79	Facility	52	$262.79	$262.79	$262.79
Medica Facility/Professional Facility Modifier 53 Low / Median / High Price $65.70 / $65.70 / $65.70	Facility	53	$65.70	$65.70	$65.70
Medica Facility/Professional Professional Modifier Low / Median / High Price $215.11 / $917.39 / $2,112.88	Professional		$215.11	$917.39	$2,112.88
Molina Facility/Professional Professional Modifier Low / Median / High Price $85.00 / $299.78 / $594.81	Professional		$85.00	$299.78	$594.81
Prevea360 Facility/Professional Facility Modifier Low / Median / High Price $72.06 / $180.55 / $465.62	Facility		$72.06	$180.55	$465.62
Quartz Facility/Professional Professional Modifier Low / Median / High Price $162.06 / $327.24 / $955.04	Professional		$162.06	$327.24	$955.04
Quartz Facility/Professional Facility Modifier Low / Median / High Price $121.96 / $462.35 / $2,776.25	Facility		$121.96	$462.35	$2,776.25
Quartz Facility/Professional Facility Modifier 52 Low / Median / High Price $97.57 / $262.79 / $262.79	Facility	52	$97.57	$262.79	$262.79
Quartz Facility/Professional Facility Modifier 53 Low / Median / High Price $24.39 / $65.70 / $65.70	Facility	53	$24.39	$65.70	$65.70
Quartz Facility/Professional Professional Modifier Low / Median / High Price $151.90 / $1,069.01 / $2,112.88	Professional		$151.90	$1,069.01	$2,112.88
Security Health Facility/Professional Professional Modifier Low / Median / High Price $259.94 / $359.81 / $1,460.00	Professional		$259.94	$359.81	$1,460.00
United Facility/Professional Facility Modifier Low / Median / High Price $2,367.00 / $2,910.00 / $4,155.00	Facility		$2,367.00	$2,910.00	$4,155.00
United Facility/Professional Professional Modifier Low / Median / High Price $223.68 / $530.09 / $1,220.67	Professional		$223.68	$530.09	$1,220.67