Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $663.50 / $3,481.28 / $6,880.70	Facility		$663.50	$3,481.28	$6,880.70
Aetna Facility/Professional Facility Modifier 52 Low / Median / High Price $100.01 / $189.84 / $620.37	Facility	52	$100.01	$189.84	$620.37
Aetna Facility/Professional Facility Modifier 53 Low / Median / High Price $74.45 / $139.22 / $348.21	Facility	53	$74.45	$139.22	$348.21
Aetna Facility/Professional Professional Modifier Low / Median / High Price $186.68 / $398.71 / $2,513.56	Professional		$186.68	$398.71	$2,513.56
Aetna Facility/Professional Professional Modifier 53 Low / Median / High Price $40.00 / $96.15 / $276.02	Professional	53	$40.00	$96.15	$276.02
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 $220.42 / $410.30 / $1,144.58	Professional		$220.42	$410.30	$1,144.58
Anthem BCBS Facility/Professional Professional Modifier 53 Low / Median / High Price $122.79 / $226.48 / $526.29	Professional	53	$122.79	$226.48	$526.29
CareSource Facility/Professional Facility Modifier Low / Median / High Price $23.82 / $165.58 / $260.85	Facility		$23.82	$165.58	$260.85
CareSource Facility/Professional Professional Modifier Low / Median / High Price $41.86 / $227.99 / $463.29	Professional		$41.86	$227.99	$463.29
Cigna Facility/Professional Facility Modifier Low / Median / High Price $906.53 / $1,059.34 / $1,625.07	Facility		$906.53	$1,059.34	$1,625.07
Cigna Facility/Professional Facility Modifier 52 Low / Median / High Price $248.66 / $248.66 / $248.66	Facility	52	$248.66	$248.66	$248.66
Cigna Facility/Professional Facility Modifier 53 Low / Median / High Price $62.17 / $62.17 / $62.17	Facility	53	$62.17	$62.17	$62.17
Cigna Facility/Professional Professional Modifier Low / Median / High Price $286.73 / $656.24 / $1,409.94	Professional		$286.73	$656.24	$1,409.94
Cigna Facility/Professional Professional Modifier 53 Low / Median / High Price $175.89 / $187.26 / $336.15	Professional	53	$175.89	$187.26	$336.15
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $190.80 / $353.87 / $665.23	Facility		$190.80	$353.87	$665.23
Medica Facility/Professional Facility Modifier Low / Median / High Price $200.02 / $433.17 / $3,242.00	Facility		$200.02	$433.17	$3,242.00
Medica Facility/Professional Facility Modifier 52 Low / Median / High Price $663.66 / $663.66 / $663.66	Facility	52	$663.66	$663.66	$663.66
Medica Facility/Professional Facility Modifier 53 Low / Median / High Price $165.92 / $165.92 / $165.92	Facility	53	$165.92	$165.92	$165.92
Medica Facility/Professional Professional Modifier Low / Median / High Price $380.99 / $1,229.50 / $2,761.67	Professional		$380.99	$1,229.50	$2,761.67
Medica Facility/Professional Professional Modifier 53 Low / Median / High Price $97.69 / $190.51 / $1,119.59	Professional	53	$97.69	$190.51	$1,119.59
Molina Facility/Professional Professional Modifier Low / Median / High Price $102.59 / $315.11 / $656.76	Professional		$102.59	$315.11	$656.76
Prevea360 Facility/Professional Facility Modifier Low / Median / High Price $192.30 / $353.91 / $665.23	Facility		$192.30	$353.91	$665.23
Quartz Facility/Professional Professional Modifier Low / Median / High Price $402.23 / $729.36 / $1,150.35	Professional		$402.23	$729.36	$1,150.35
Quartz Facility/Professional Facility Modifier Low / Median / High Price $310.83 / $1,063.59 / $2,776.25	Facility		$310.83	$1,063.59	$2,776.25
Quartz Facility/Professional Facility Modifier 52 Low / Median / High Price $248.66 / $663.66 / $663.66	Facility	52	$248.66	$663.66	$663.66
Quartz Facility/Professional Facility Modifier 53 Low / Median / High Price $62.17 / $165.92 / $165.92	Facility	53	$62.17	$165.92	$165.92
Quartz Facility/Professional Professional Modifier Low / Median / High Price $349.23 / $1,356.96 / $2,761.67	Professional		$349.23	$1,356.96	$2,761.67
Security Health Facility/Professional Professional Modifier Low / Median / High Price $666.60 / $1,487.00 / $1,487.00	Professional		$666.60	$1,487.00	$1,487.00
Security Health Facility/Professional Professional Modifier 53 Low / Median / High Price $320.73 / $472.23 / $683.30	Professional	53	$320.73	$472.23	$683.30
United Facility/Professional Facility Modifier Low / Median / High Price $2,976.00 / $3,827.00 / $5,471.00	Facility		$2,976.00	$3,827.00	$5,471.00
United Facility/Professional Professional Modifier Low / Median / High Price $346.89 / $699.38 / $1,441.07	Professional		$346.89	$699.38	$1,441.07
United Facility/Professional Professional Modifier 53 Low / Median / High Price $81.16 / $422.53 / $736.57	Professional	53	$81.16	$422.53	$736.57