Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $726.25 / $7,561.75 / $14,070.38	Facility		$726.25	$7,561.75	$14,070.38
Aetna Facility/Professional Facility Modifier 52 Low / Median / High Price $123.05 / $413.55 / $2,299.12	Facility	52	$123.05	$413.55	$2,299.12
Aetna Facility/Professional Facility Modifier 53 Low / Median / High Price $49.22 / $165.42 / $919.65	Facility	53	$49.22	$165.42	$919.65
Aetna Facility/Professional Professional Modifier Low / Median / High Price $246.10 / $691.03 / $4,304.00	Professional		$246.10	$691.03	$4,304.00
Aetna Facility/Professional Professional Modifier 53 Low / Median / High Price $49.22 / $180.40 / $516.01	Professional	53	$49.22	$180.40	$516.01
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 $402.32 / $1,335.51 / $6,075.81	Professional		$402.32	$1,335.51	$6,075.81
CareSource Facility/Professional Facility Modifier Low / Median / High Price $219.31 / $334.41 / $334.41	Facility		$219.31	$334.41	$334.41
CareSource Facility/Professional Professional Modifier Low / Median / High Price $1,169.18 / $1,605.02 / $2,480.87	Professional		$1,169.18	$1,605.02	$2,480.87
Cigna Facility/Professional Facility Modifier Low / Median / High Price $3,597.27 / $4,203.70 / $6,780.41	Facility		$3,597.27	$4,203.70	$6,780.41
Cigna Facility/Professional Professional Modifier Low / Median / High Price $412.51 / $1,892.03 / $4,721.58	Professional		$412.51	$1,892.03	$4,721.58
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $238.64 / $804.31 / $1,870.19	Facility		$238.64	$804.31	$1,870.19
Medica Facility/Professional Facility Modifier Low / Median / High Price $278.49 / $1,915.34 / $8,129.86	Facility		$278.49	$1,915.34	$8,129.86
Medica Facility/Professional Professional Modifier Low / Median / High Price $484.22 / $3,112.64 / $6,532.88	Professional		$484.22	$3,112.64	$6,532.88
Molina Facility/Professional Professional Modifier Low / Median / High Price $85.00 / $1,130.67 / $2,740.61	Professional		$85.00	$1,130.67	$2,740.61
Prevea360 Facility/Professional Facility Modifier Low / Median / High Price $238.64 / $804.31 / $1,870.19	Facility		$238.64	$804.31	$1,870.19
Quartz Facility/Professional Professional Modifier Low / Median / High Price $529.73 / $1,207.30 / $4,412.34	Professional		$529.73	$1,207.30	$4,412.34
Quartz Facility/Professional Facility Modifier Low / Median / High Price $2,131.86 / $2,131.86 / $2,131.86	Facility		$2,131.86	$2,131.86	$2,131.86
Quartz Facility/Professional Facility Modifier 52 Low / Median / High Price $840.46 / $840.46 / $840.46	Facility	52	$840.46	$840.46	$840.46
Quartz Facility/Professional Facility Modifier 53 Low / Median / High Price $210.11 / $210.11 / $210.11	Facility	53	$210.11	$210.11	$210.11
Quartz Facility/Professional Professional Modifier Low / Median / High Price $384.09 / $4,931.93 / $9,714.64	Professional		$384.09	$4,931.93	$9,714.64
Security Health Facility/Professional Professional Modifier Low / Median / High Price $649.91 / $1,223.15 / $7,231.36	Professional		$649.91	$1,223.15	$7,231.36
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 $516.66 / $3,374.50 / $5,915.50	Professional		$516.66	$3,374.50	$5,915.50