Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $669.13 / $3,119.00 / $9,199.45	Facility		$669.13	$3,119.00	$9,199.45
Aetna Facility/Professional Facility Modifier 52 Low / Median / High Price $180.47 / $334.56 / $596.27	Facility	52	$180.47	$334.56	$596.27
Aetna Facility/Professional Facility Modifier 53 Low / Median / High Price $72.19 / $133.83 / $238.51	Facility	53	$72.19	$133.83	$238.51
Aetna Facility/Professional Professional Modifier Low / Median / High Price $318.36 / $460.90 / $1,397.60	Professional		$318.36	$460.90	$1,397.60
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 $328.36 / $713.54 / $2,007.69	Professional		$328.36	$713.54	$2,007.69
CareSource Facility/Professional Facility Modifier Low / Median / High Price $308.97 / $386.71 / $466.55	Facility		$308.97	$386.71	$466.55
CareSource Facility/Professional Professional Modifier Low / Median / High Price $308.97 / $393.72 / $721.13	Professional		$308.97	$393.72	$721.13
Cigna Facility/Professional Facility Modifier Low / Median / High Price $844.35 / $986.69 / $1,513.61	Facility		$844.35	$986.69	$1,513.61
Cigna Facility/Professional Facility Modifier 52 Low / Median / High Price $291.99 / $291.99 / $291.99	Facility	52	$291.99	$291.99	$291.99
Cigna Facility/Professional Facility Modifier 53 Low / Median / High Price $73.00 / $73.00 / $73.00	Facility	53	$73.00	$73.00	$73.00
Cigna Facility/Professional Professional Modifier Low / Median / High Price $435.60 / $1,182.59 / $1,343.86	Professional		$435.60	$1,182.59	$1,343.86
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $321.37 / $401.48 / $652.29	Facility		$321.37	$401.48	$652.29
Medica Facility/Professional Facility Modifier Low / Median / High Price $317.20 / $497.87 / $4,821.00	Facility		$317.20	$497.87	$4,821.00
Medica Facility/Professional Facility Modifier 52 Low / Median / High Price $6,012.68 / $6,012.68 / $6,012.68	Facility	52	$6,012.68	$6,012.68	$6,012.68
Medica Facility/Professional Facility Modifier 53 Low / Median / High Price $1,503.17 / $1,503.17 / $1,503.17	Facility	53	$1,503.17	$1,503.17	$1,503.17
Medica Facility/Professional Professional Modifier Low / Median / High Price $357.84 / $712.43 / $2,445.36	Professional		$357.84	$712.43	$2,445.36
Molina Facility/Professional Professional Modifier Low / Median / High Price $70.00 / $531.30 / $781.95	Professional		$70.00	$531.30	$781.95
Prevea360 Facility/Professional Facility Modifier Low / Median / High Price $311.52 / $402.94 / $661.24	Facility		$311.52	$402.94	$661.24
Quartz Facility/Professional Professional Modifier Low / Median / High Price $588.00 / $784.20 / $1,359.52	Professional		$588.00	$784.20	$1,359.52
Quartz Facility/Professional Facility Modifier Low / Median / High Price $373.67 / $7,929.30 / $7,929.30	Facility		$373.67	$7,929.30	$7,929.30
Quartz Facility/Professional Facility Modifier 52 Low / Median / High Price $291.99 / $6,012.68 / $6,012.68	Facility	52	$291.99	$6,012.68	$6,012.68
Quartz Facility/Professional Facility Modifier 53 Low / Median / High Price $73.00 / $1,503.17 / $1,503.17	Facility	53	$73.00	$1,503.17	$1,503.17
Quartz Facility/Professional Professional Modifier Low / Median / High Price $532.00 / $1,626.55 / $2,445.36	Professional		$532.00	$1,626.55	$2,445.36
Security Health Facility/Professional Professional Modifier Low / Median / High Price $1,081.00 / $1,640.89 / $1,640.89	Professional		$1,081.00	$1,640.89	$1,640.89
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 $350.29 / $682.60 / $1,467.96	Professional		$350.29	$682.60	$1,467.96