Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $1,547.38 / $13,486.11 / $32,552.65	Facility		$1,547.38	$13,486.11	$32,552.65
Aetna Facility/Professional Facility Modifier 50 Low / Median / High Price $11,207.12 / $17,269.25 / $37,660.66	Facility	50	$11,207.12	$17,269.25	$37,660.66
Aetna Facility/Professional Professional Modifier Low / Median / High Price $383.69 / $647.20 / $2,698.24	Professional		$383.69	$647.20	$2,698.24
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $7,084.00 / $11,791.00 / $18,603.00	Facility		$7,084.00	$11,791.00	$18,603.00
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $405.11 / $949.59 / $2,438.63	Professional		$405.11	$949.59	$2,438.63
CareSource Facility/Professional Facility Modifier Low / Median / High Price $414.15 / $517.69 / $631.83	Facility		$414.15	$517.69	$631.83
CareSource Facility/Professional Professional Modifier Low / Median / High Price $407.23 / $522.83 / $976.62	Professional		$407.23	$522.83	$976.62
Cigna Facility/Professional Facility Modifier Low / Median / High Price $1,092.16 / $1,276.27 / $2,058.58	Facility		$1,092.16	$1,276.27	$2,058.58
Cigna Facility/Professional Facility Modifier AS Low / Median / High Price $48.91 / $48.91 / $48.91	Facility	AS	$48.91	$48.91	$48.91
Cigna Facility/Professional Professional Modifier Low / Median / High Price $514.08 / $1,429.03 / $1,730.95	Professional		$514.08	$1,429.03	$1,730.95
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $417.33 / $558.00 / $1,120.00	Facility		$417.33	$558.00	$1,120.00
Medica Facility/Professional Facility Modifier Low / Median / High Price $417.33 / $669.02 / $13,982.00	Facility		$417.33	$669.02	$13,982.00
Medica Facility/Professional Facility Modifier 50 Low / Median / High Price $4,692.26 / $10,020.00 / $12,583.43	Facility	50	$4,692.26	$10,020.00	$12,583.43
Medica Facility/Professional Facility Modifier AS Low / Median / High Price $1,537.78 / $1,537.78 / $1,537.78	Facility	AS	$1,537.78	$1,537.78	$1,537.78
Medica Facility/Professional Professional Modifier Low / Median / High Price $446.22 / $962.15 / $3,959.35	Professional		$446.22	$962.15	$3,959.35
Molina Facility/Professional Professional Modifier Low / Median / High Price $57.10 / $339.92 / $924.86	Professional		$57.10	$339.92	$924.86
Prevea360 Facility/Professional Facility Modifier Low / Median / High Price $417.33 / $558.00 / $1,157.64	Facility		$417.33	$558.00	$1,157.64
Quartz Facility/Professional Professional Modifier Low / Median / High Price $793.20 / $1,057.85 / $1,751.12	Professional		$793.20	$1,057.85	$1,751.12
Quartz Facility/Professional Facility Modifier Low / Median / High Price $493.18 / $16,223.75 / $16,223.75	Facility		$493.18	$16,223.75	$16,223.75
Quartz Facility/Professional Facility Modifier AS Low / Median / High Price $48.91 / $1,537.78 / $1,537.78	Facility	AS	$48.91	$1,537.78	$1,537.78
Quartz Facility/Professional Professional Modifier Low / Median / High Price $724.87 / $2,028.25 / $3,959.35	Professional		$724.87	$2,028.25	$3,959.35
Security Health Facility/Professional Professional Modifier Low / Median / High Price $1,482.30 / $2,113.46 / $2,113.46	Professional		$1,482.30	$2,113.46	$2,113.46
United Facility/Professional Facility Modifier Low / Median / High Price $8,627.00 / $12,373.00 / $15,903.00	Facility		$8,627.00	$12,373.00	$15,903.00
United Facility/Professional Professional Modifier Low / Median / High Price $412.50 / $815.54 / $1,830.50	Professional		$412.50	$815.54	$1,830.50