Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $710.94 / $3,584.84 / $7,136.64	Facility		$710.94	$3,584.84	$7,136.64
Aetna Facility/Professional Facility Modifier 52 Low / Median / High Price $137.90 / $255.93 / $825.42	Facility	52	$137.90	$255.93	$825.42
Aetna Facility/Professional Facility Modifier 53 Low / Median / High Price $55.16 / $102.37 / $330.17	Facility	53	$55.16	$102.37	$330.17
Aetna Facility/Professional Professional Modifier Low / Median / High Price $244.87 / $466.68 / $2,290.56	Professional		$244.87	$466.68	$2,290.56
Aetna Facility/Professional Professional Modifier 53 Low / Median / High Price $49.56 / $88.10 / $208.61	Professional	53	$49.56	$88.10	$208.61
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 $303.33 / $565.74 / $1,581.36	Professional		$303.33	$565.74	$1,581.36
CareSource Facility/Professional Facility Modifier Low / Median / High Price $236.67 / $295.87 / $357.50	Facility		$236.67	$295.87	$357.50
CareSource Facility/Professional Professional Modifier Low / Median / High Price $412.00 / $520.87 / $937.22	Professional		$412.00	$520.87	$937.22
Cigna Facility/Professional Facility Modifier Low / Median / High Price $1,209.30 / $1,413.17 / $2,167.83	Facility		$1,209.30	$1,413.17	$2,167.83
Cigna Facility/Professional Facility Modifier 52 Low / Median / High Price $341.33 / $341.33 / $341.33	Facility	52	$341.33	$341.33	$341.33
Cigna Facility/Professional Facility Modifier 53 Low / Median / High Price $85.33 / $85.33 / $85.33	Facility	53	$85.33	$85.33	$85.33
Cigna Facility/Professional Professional Modifier Low / Median / High Price $393.58 / $903.74 / $1,883.19	Professional		$393.58	$903.74	$1,883.19
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $262.42 / $485.95 / $899.25	Facility		$262.42	$485.95	$899.25
Medica Facility/Professional Facility Modifier Low / Median / High Price $275.80 / $667.30 / $3,305.54	Facility		$275.80	$667.30	$3,305.54
Medica Facility/Professional Facility Modifier 52 Low / Median / High Price $909.50 / $909.50 / $909.50	Facility	52	$909.50	$909.50	$909.50
Medica Facility/Professional Facility Modifier 53 Low / Median / High Price $227.37 / $227.37 / $227.37	Facility	53	$227.37	$227.37	$227.37
Medica Facility/Professional Professional Modifier Low / Median / High Price $516.70 / $1,697.25 / $3,439.23	Professional		$516.70	$1,697.25	$3,439.23
Medica Facility/Professional Professional Modifier 53 Low / Median / High Price $1,326.15 / $1,326.15 / $1,719.45	Professional	53	$1,326.15	$1,326.15	$1,719.45
Molina Facility/Professional Professional Modifier Low / Median / High Price $85.00 / $749.84 / $1,138.31	Professional		$85.00	$749.84	$1,138.31
Prevea360 Facility/Professional Facility Modifier Low / Median / High Price $265.17 / $489.10 / $885.11	Facility		$265.17	$489.10	$885.11
Quartz Facility/Professional Professional Modifier Low / Median / High Price $547.70 / $969.12 / $1,528.52	Professional		$547.70	$969.12	$1,528.52
Quartz Facility/Professional Facility Modifier Low / Median / High Price $426.66 / $1,462.80 / $3,590.15	Facility		$426.66	$1,462.80	$3,590.15
Quartz Facility/Professional Facility Modifier 52 Low / Median / High Price $341.33 / $909.50 / $909.50	Facility	52	$341.33	$909.50	$909.50
Quartz Facility/Professional Facility Modifier 53 Low / Median / High Price $85.33 / $227.37 / $227.37	Facility	53	$85.33	$227.37	$227.37
Quartz Facility/Professional Professional Modifier Low / Median / High Price $480.96 / $1,906.00 / $3,439.23	Professional		$480.96	$1,906.00	$3,439.23
Security Health Facility/Professional Professional Modifier Low / Median / High Price $919.43 / $2,159.76 / $2,332.54	Professional		$919.43	$2,159.76	$2,332.54
United Facility/Professional Facility Modifier Low / Median / High Price $2,781.00 / $3,827.00 / $6,072.00	Facility		$2,781.00	$3,827.00	$6,072.00
United Facility/Professional Professional Modifier Low / Median / High Price $461.95 / $942.97 / $1,942.99	Professional		$461.95	$942.97	$1,942.99