Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $487.12 / $3,846.53 / $8,313.91	Facility		$487.12	$3,846.53	$8,313.91
Aetna Facility/Professional Facility Modifier 52 Low / Median / High Price $108.91 / $243.56 / $786.54	Facility	52	$108.91	$243.56	$786.54
Aetna Facility/Professional Facility Modifier 53 Low / Median / High Price $43.56 / $97.42 / $314.62	Facility	53	$43.56	$97.42	$314.62
Aetna Facility/Professional Professional Modifier Low / Median / High Price $195.69 / $463.04 / $2,958.00	Professional		$195.69	$463.04	$2,958.00
Aetna Facility/Professional Professional Modifier 52 Low / Median / High Price $97.76 / $205.38 / $439.64	Professional	52	$97.76	$205.38	$439.64
Aetna Facility/Professional Professional Modifier 53 Low / Median / High Price $39.10 / $81.06 / $146.13	Professional	53	$39.10	$81.06	$146.13
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 $245.27 / $446.80 / $1,352.84	Professional		$245.27	$446.80	$1,352.84
CareSource Facility/Professional Facility Modifier Low / Median / High Price $187.73 / $234.66 / $283.85	Facility		$187.73	$234.66	$283.85
CareSource Facility/Professional Professional Modifier Low / Median / High Price $389.88 / $491.91 / $882.24	Professional		$389.88	$491.91	$882.24
Cigna Facility/Professional Facility Modifier Low / Median / High Price $1,162.44 / $1,358.41 / $2,083.83	Facility		$1,162.44	$1,358.41	$2,083.83
Cigna Facility/Professional Facility Modifier 52 Low / Median / High Price $270.52 / $270.52 / $270.52	Facility	52	$270.52	$270.52	$270.52
Cigna Facility/Professional Facility Modifier 53 Low / Median / High Price $67.63 / $67.63 / $67.63	Facility	53	$67.63	$67.63	$67.63
Cigna Facility/Professional Professional Modifier Low / Median / High Price $315.76 / $714.26 / $1,802.35	Professional		$315.76	$714.26	$1,802.35
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $207.38 / $427.14 / $818.41	Facility		$207.38	$427.14	$818.41
Medica Facility/Professional Facility Modifier Low / Median / High Price $217.81 / $569.92 / $3,231.52	Facility		$217.81	$569.92	$3,231.52
Medica Facility/Professional Facility Modifier 52 Low / Median / High Price $721.81 / $721.81 / $721.81	Facility	52	$721.81	$721.81	$721.81
Medica Facility/Professional Facility Modifier 53 Low / Median / High Price $180.45 / $180.45 / $180.45	Facility	53	$180.45	$180.45	$180.45
Medica Facility/Professional Professional Modifier Low / Median / High Price $434.22 / $1,400.60 / $3,212.16	Professional		$434.22	$1,400.60	$3,212.16
Medica Facility/Professional Professional Modifier 53 Low / Median / High Price $88.06 / $1,446.30 / $1,926.00	Professional	53	$88.06	$1,446.30	$1,926.00
Molina Facility/Professional Professional Modifier Low / Median / High Price $85.00 / $669.66 / $1,090.12	Professional		$85.00	$669.66	$1,090.12
Prevea360 Facility/Professional Facility Modifier Low / Median / High Price $207.61 / $414.38 / $818.41	Facility		$207.61	$414.38	$818.41
Quartz Facility/Professional Professional Modifier Low / Median / High Price $442.02 / $833.30 / $1,455.84	Professional		$442.02	$833.30	$1,455.84
Quartz Facility/Professional Facility Modifier Low / Median / High Price $338.16 / $1,156.15 / $3,590.15	Facility		$338.16	$1,156.15	$3,590.15
Quartz Facility/Professional Facility Modifier 52 Low / Median / High Price $270.52 / $721.81 / $721.81	Facility	52	$270.52	$721.81	$721.81
Quartz Facility/Professional Facility Modifier 53 Low / Median / High Price $67.63 / $180.45 / $180.45	Facility	53	$67.63	$180.45	$180.45
Quartz Facility/Professional Professional Modifier Low / Median / High Price $380.10 / $1,640.36 / $3,212.16	Professional		$380.10	$1,640.36	$3,212.16
Security Health Facility/Professional Professional Modifier Low / Median / High Price $725.04 / $1,916.76 / $1,924.34	Professional		$725.04	$1,916.76	$1,924.34
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 $412.72 / $833.40 / $1,862.40	Professional		$412.72	$833.40	$1,862.40