Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $521.89 / $1,338.89 / $6,880.70	Facility		$521.89	$1,338.89	$6,880.70
Aetna Facility/Professional Facility Modifier 52 Low / Median / High Price $140.63 / $375.10 / $1,193.09	Facility	52	$140.63	$375.10	$1,193.09
Aetna Facility/Professional Facility Modifier 53 Low / Median / High Price $56.25 / $150.04 / $477.24	Facility	53	$56.25	$150.04	$477.24
Aetna Facility/Professional Professional Modifier Low / Median / High Price $255.65 / $594.40 / $1,142.20	Professional		$255.65	$594.40	$1,142.20
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 $316.70 / $691.41 / $1,612.63	Professional		$316.70	$691.41	$1,612.63
Cigna Facility/Professional Facility Modifier Low / Median / High Price $1,788.72 / $2,090.26 / $3,206.52	Facility		$1,788.72	$2,090.26	$3,206.52
Cigna Facility/Professional Facility Modifier 52 Low / Median / High Price $347.70 / $347.70 / $347.70	Facility	52	$347.70	$347.70	$347.70
Cigna Facility/Professional Facility Modifier 53 Low / Median / High Price $86.93 / $86.93 / $86.93	Facility	53	$86.93	$86.93	$86.93
Cigna Facility/Professional Professional Modifier Low / Median / High Price $411.10 / $1,046.69 / $2,761.84	Professional		$411.10	$1,046.69	$2,761.84
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $267.37 / $627.33 / $1,279.38	Facility		$267.37	$627.33	$1,279.38
Medica Facility/Professional Facility Modifier Low / Median / High Price $271.07 / $668.70 / $3,024.34	Facility		$271.07	$668.70	$3,024.34
Medica Facility/Professional Facility Modifier 52 Low / Median / High Price $926.46 / $926.46 / $926.46	Facility	52	$926.46	$926.46	$926.46
Medica Facility/Professional Facility Modifier 53 Low / Median / High Price $231.61 / $231.61 / $231.61	Facility	53	$231.61	$231.61	$231.61
Medica Facility/Professional Professional Modifier Low / Median / High Price $701.95 / $2,318.94 / $4,908.96	Professional		$701.95	$2,318.94	$4,908.96
Molina Facility/Professional Professional Modifier Low / Median / High Price $85.00 / $969.74 / $1,645.48	Professional		$85.00	$969.74	$1,645.48
Prevea360 Facility/Professional Facility Modifier Low / Median / High Price $267.37 / $612.94 / $1,279.38	Facility		$267.37	$612.94	$1,279.38
Quartz Facility/Professional Professional Modifier Low / Median / High Price $572.51 / $1,185.57 / $2,200.79	Professional		$572.51	$1,185.57	$2,200.79
Quartz Facility/Professional Facility Modifier Low / Median / High Price $434.63 / $1,489.15 / $3,590.15	Facility		$434.63	$1,489.15	$3,590.15
Quartz Facility/Professional Facility Modifier 52 Low / Median / High Price $347.70 / $926.46 / $926.46	Facility	52	$347.70	$926.46	$926.46
Quartz Facility/Professional Facility Modifier 53 Low / Median / High Price $86.93 / $231.61 / $231.61	Facility	53	$86.93	$231.61	$231.61
Quartz Facility/Professional Professional Modifier Low / Median / High Price $490.18 / $2,494.73 / $4,908.96	Professional		$490.18	$2,494.73	$4,908.96
Security Health Facility/Professional Professional Modifier Low / Median / High Price $1,073.72 / $1,278.02 / $3,372.21	Professional		$1,073.72	$1,278.02	$3,372.21
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 $700.70 / $1,396.48 / $3,080.68	Professional		$700.70	$1,396.48	$3,080.68