Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $4,614.56 / $11,002.94 / $25,473.55	Facility		$4,614.56	$11,002.94	$25,473.55
Aetna Facility/Professional Facility Modifier 50 Low / Median / High Price $8,243.00 / $11,596.34 / $15,378.05	Facility	50	$8,243.00	$11,596.34	$15,378.05
Aetna Facility/Professional Professional Modifier Low / Median / High Price $413.57 / $1,644.00 / $5,647.80	Professional		$413.57	$1,644.00	$5,647.80
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $6,538.00 / $9,948.00 / $15,579.70	Facility		$6,538.00	$9,948.00	$15,579.70
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $408.43 / $1,047.90 / $2,800.27	Professional		$408.43	$1,047.90	$2,800.27
CareSource Facility/Professional Facility Modifier Low / Median / High Price $389.90 / $591.00 / $591.00	Facility		$389.90	$591.00	$591.00
CareSource Facility/Professional Professional Modifier Low / Median / High Price $392.60 / $591.00 / $913.51	Professional		$392.60	$591.00	$913.51
Cigna Facility/Professional Facility Modifier Low / Median / High Price $1,048.00 / $1,224.67 / $1,975.36	Facility		$1,048.00	$1,224.67	$1,975.36
Cigna Facility/Professional Professional Modifier Low / Median / High Price $555.55 / $1,273.73 / $1,677.92	Professional		$555.55	$1,273.73	$1,677.92
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $410.15 / $483.88 / $801.65	Facility		$410.15	$483.88	$801.65
Medica Facility/Professional Facility Modifier Low / Median / High Price $413.57 / $6,621.30 / $13,577.38	Facility		$413.57	$6,621.30	$13,577.38
Medica Facility/Professional Facility Modifier 50 Low / Median / High Price $5,020.10 / $5,020.10 / $5,597.10	Facility	50	$5,020.10	$5,020.10	$5,597.10
Medica Facility/Professional Professional Modifier Low / Median / High Price $465.50 / $1,112.82 / $2,443.10	Professional		$465.50	$1,112.82	$2,443.10
Molina Facility/Professional Professional Modifier Low / Median / High Price $85.00 / $412.61 / $933.98	Professional		$85.00	$412.61	$933.98
Prevea360 Facility/Professional Facility Modifier Low / Median / High Price $410.15 / $483.88 / $801.65	Facility		$410.15	$483.88	$801.65
Quartz Facility/Professional Professional Modifier Low / Median / High Price $800.80 / $1,236.56 / $1,685.81	Professional		$800.80	$1,236.56	$1,685.81
Quartz Facility/Professional Facility Modifier Low / Median / High Price $14,302.50 / $14,302.50 / $14,302.50	Facility		$14,302.50	$14,302.50	$14,302.50
Quartz Facility/Professional Professional Modifier Low / Median / High Price $567.61 / $2,023.30 / $3,057.36	Professional		$567.61	$2,023.30	$3,057.36
Security Health Facility/Professional Professional Modifier Low / Median / High Price $1,950.37 / $2,408.46 / $2,408.46	Professional		$1,950.37	$2,408.46	$2,408.46
United Facility/Professional Facility Modifier Low / Median / High Price $7,217.00 / $11,608.00 / $13,980.00	Facility		$7,217.00	$11,608.00	$13,980.00
United Facility/Professional Professional Modifier Low / Median / High Price $464.26 / $1,240.35 / $1,971.30	Professional		$464.26	$1,240.35	$1,971.30