Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $1,044.47 / $10,489.72 / $14,461.97	Facility		$1,044.47	$10,489.72	$14,461.97
Aetna Facility/Professional Facility Modifier 50 Low / Median / High Price $3,058.88 / $7,038.24 / $11,342.70	Facility	50	$3,058.88	$7,038.24	$11,342.70
Aetna Facility/Professional Professional Modifier Low / Median / High Price $465.97 / $624.44 / $3,893.00	Professional		$465.97	$624.44	$3,893.00
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $5,169.00 / $8,139.00 / $10,914.00	Facility		$5,169.00	$8,139.00	$10,914.00
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $490.98 / $1,144.27 / $2,937.31	Professional		$490.98	$1,144.27	$2,937.31
CareSource Facility/Professional Facility Modifier Low / Median / High Price $500.48 / $625.60 / $765.45	Facility		$500.48	$625.60	$765.45
CareSource Facility/Professional Professional Modifier Low / Median / High Price $490.71 / $632.02 / $1,183.16	Professional		$490.71	$632.02	$1,183.16
Cigna Facility/Professional Facility Modifier Low / Median / High Price $1,312.03 / $1,533.21 / $2,473.02	Facility		$1,312.03	$1,533.21	$2,473.02
Cigna Facility/Professional Facility Modifier AS Low / Median / High Price $58.98 / $58.98 / $58.98	Facility	AS	$58.98	$58.98	$58.98
Cigna Facility/Professional Professional Modifier Low / Median / High Price $568.51 / $1,739.70 / $2,082.67	Professional		$568.51	$1,739.70	$2,082.67
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $503.88 / $676.01 / $1,165.50	Facility		$503.88	$676.01	$1,165.50
Medica Facility/Professional Facility Modifier Low / Median / High Price $507.26 / $835.58 / $9,558.29	Facility		$507.26	$835.58	$9,558.29
Medica Facility/Professional Facility Modifier AS Low / Median / High Price $905.99 / $905.99 / $905.99	Facility	AS	$905.99	$905.99	$905.99
Medica Facility/Professional Professional Modifier Low / Median / High Price $540.58 / $1,184.76 / $4,067.23	Professional		$540.58	$1,184.76	$4,067.23
Molina Facility/Professional Professional Modifier Low / Median / High Price $65.50 / $465.59 / $1,112.39	Professional		$65.50	$465.59	$1,112.39
Prevea360 Facility/Professional Facility Modifier Low / Median / High Price $503.88 / $669.52 / $1,165.50	Facility		$503.88	$669.52	$1,165.50
Quartz Facility/Professional Professional Modifier Low / Median / High Price $956.40 / $1,275.52 / $2,106.94	Professional		$956.40	$1,275.52	$2,106.94
Quartz Facility/Professional Facility Modifier Low / Median / High Price $596.21 / $9,558.29 / $9,558.29	Facility		$596.21	$9,558.29	$9,558.29
Quartz Facility/Professional Facility Modifier AS Low / Median / High Price $58.98 / $905.99 / $905.99	Facility	AS	$58.98	$905.99	$905.99
Quartz Facility/Professional Professional Modifier Low / Median / High Price $879.73 / $2,457.19 / $4,067.23	Professional		$879.73	$2,457.19	$4,067.23
Security Health Facility/Professional Professional Modifier Low / Median / High Price $1,538.78 / $2,543.00 / $2,543.00	Professional		$1,538.78	$2,543.00	$2,543.00
United Facility/Professional Facility Modifier Low / Median / High Price $6,073.00 / $9,953.00 / $12,062.00	Facility		$6,073.00	$9,953.00	$12,062.00
United Facility/Professional Professional Modifier Low / Median / High Price $529.49 / $1,053.22 / $2,217.62	Professional		$529.49	$1,053.22	$2,217.62