Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $382.29 / $2,174.59 / $8,136.21	Facility		$382.29	$2,174.59	$8,136.21
Aetna Facility/Professional Facility Modifier 53 Low / Median / High Price $76.45 / $304.50 / $1,627.24	Facility	53	$76.45	$304.50	$1,627.24
Aetna Facility/Professional Professional Modifier Low / Median / High Price $382.29 / $1,065.74 / $4,005.42	Professional		$382.29	$1,065.74	$4,005.42
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $10,878.00 / $15,141.00 / $22,609.00	Facility		$10,878.00	$15,141.00	$22,609.00
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $552.41 / $1,173.84 / $2,368.25	Professional		$552.41	$1,173.84	$2,368.25
CareSource Facility/Professional Facility Modifier Low / Median / High Price $391.58 / $469.90 / $588.59	Facility		$391.58	$469.90	$588.59
CareSource Facility/Professional Professional Modifier Low / Median / High Price $1,967.64 / $2,066.02 / $2,652.82	Professional		$1,967.64	$2,066.02	$2,652.82
Cigna Facility/Professional Facility Modifier Low / Median / High Price $6,239.35 / $7,291.18 / $11,184.86	Facility		$6,239.35	$7,291.18	$11,184.86
Cigna Facility/Professional Professional Modifier Low / Median / High Price $757.86 / $1,960.38 / $10,204.23	Professional		$757.86	$1,960.38	$10,204.23
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $382.29 / $949.18 / $3,327.12	Facility		$382.29	$949.18	$3,327.12
Medica Facility/Professional Facility Modifier Low / Median / High Price $404.59 / $2,193.10 / $13,721.00	Facility		$404.59	$2,193.10	$13,721.00
Medica Facility/Professional Professional Modifier Low / Median / High Price $1,662.03 / $4,054.46 / $16,822.72	Professional		$1,662.03	$4,054.46	$16,822.72
Molina Facility/Professional Professional Modifier Low / Median / High Price $209.15 / $1,686.18 / $4,544.51	Professional		$209.15	$1,686.18	$4,544.51
Prevea360 Facility/Professional Facility Modifier Low / Median / High Price $403.31 / $949.18 / $3,327.12	Facility		$403.31	$949.18	$3,327.12
Quartz Facility/Professional Professional Modifier Low / Median / High Price $951.85 / $2,365.39 / $7,113.92	Professional		$951.85	$2,365.39	$7,113.92
Quartz Facility/Professional Facility Modifier Low / Median / High Price $2,914.92 / $2,914.92 / $10,446.84	Facility		$2,914.92	$2,914.92	$10,446.84
Quartz Facility/Professional Facility Modifier 53 Low / Median / High Price $377.84 / $377.84 / $377.84	Facility	53	$377.84	$377.84	$377.84
Quartz Facility/Professional Professional Modifier Low / Median / High Price $970.45 / $8,468.69 / $16,822.72	Professional		$970.45	$8,468.69	$16,822.72
Security Health Facility/Professional Professional Modifier Low / Median / High Price $1,486.47 / $2,410.35 / $13,446.30	Professional		$1,486.47	$2,410.35	$13,446.30
United Facility/Professional Facility Modifier Low / Median / High Price $5,356.00 / $12,373.00 / $15,090.00	Facility		$5,356.00	$12,373.00	$15,090.00
United Facility/Professional Professional Modifier Low / Median / High Price $1,715.50 / $3,576.64 / $8,113.54	Professional		$1,715.50	$3,576.64	$8,113.54