Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $611.79 / $3,250.47 / $12,486.20	Facility		$611.79	$3,250.47	$12,486.20
Aetna Facility/Professional Facility Modifier 52 Low / Median / High Price $150.79 / $305.89 / $545.17	Facility	52	$150.79	$305.89	$545.17
Aetna Facility/Professional Facility Modifier 53 Low / Median / High Price $60.32 / $122.36 / $218.07	Facility	53	$60.32	$122.36	$218.07
Aetna Facility/Professional Professional Modifier Low / Median / High Price $301.58 / $462.46 / $3,383.00	Professional		$301.58	$462.46	$3,383.00
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $2,740.00 / $4,780.00 / $7,344.00	Facility		$2,740.00	$4,780.00	$7,344.00
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $296.83 / $804.89 / $2,038.19	Professional		$296.83	$804.89	$2,038.19
Cigna Facility/Professional Facility Modifier Low / Median / High Price $765.05 / $894.02 / $1,442.03	Facility		$765.05	$894.02	$1,442.03
Cigna Facility/Professional Professional Modifier Low / Median / High Price $405.15 / $929.21 / $1,224.08	Professional		$405.15	$929.21	$1,224.08
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $301.58 / $415.58 / $2,265.31	Facility		$301.58	$415.58	$2,265.31
Medica Facility/Professional Facility Modifier Low / Median / High Price $301.58 / $3,193.00 / $8,783.00	Facility		$301.58	$3,193.00	$8,783.00
Medica Facility/Professional Professional Modifier Low / Median / High Price $351.90 / $809.63 / $2,038.46	Professional		$351.90	$809.63	$2,038.46
Molina Facility/Professional Professional Modifier Low / Median / High Price $85.00 / $421.66 / $783.93	Professional		$85.00	$421.66	$783.93
Prevea360 Facility/Professional Facility Modifier Low / Median / High Price $301.58 / $415.58 / $2,265.31	Facility		$301.58	$415.58	$2,265.31
Quartz Facility/Professional Professional Modifier Low / Median / High Price $584.35 / $902.33 / $1,227.70	Professional		$584.35	$902.33	$1,227.70
Quartz Facility/Professional Facility Modifier Low / Median / High Price $9,388.90 / $9,388.90 / $9,388.90	Facility		$9,388.90	$9,388.90	$9,388.90
Quartz Facility/Professional Facility Modifier 52 Low / Median / High Price $7,119.48 / $7,119.48 / $7,119.48	Facility	52	$7,119.48	$7,119.48	$7,119.48
Quartz Facility/Professional Facility Modifier 53 Low / Median / High Price $1,779.87 / $1,779.87 / $1,779.87	Facility	53	$1,779.87	$1,779.87	$1,779.87
Quartz Facility/Professional Professional Modifier Low / Median / High Price $414.09 / $1,472.05 / $2,853.12	Professional		$414.09	$1,472.05	$2,853.12
Security Health Facility/Professional Professional Modifier Low / Median / High Price $1,361.73 / $1,757.00 / $1,757.00	Professional		$1,361.73	$1,757.00	$1,757.00
United Facility/Professional Facility Modifier Low / Median / High Price $4,918.00 / $6,477.00 / $8,384.00	Facility		$4,918.00	$6,477.00	$8,384.00
United Facility/Professional Professional Modifier Low / Median / High Price $331.34 / $865.41 / $1,437.47	Professional		$331.34	$865.41	$1,437.47