Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $75.92 / $208.42 / $1,894.00	Facility		$75.92	$208.42	$1,894.00
Aetna Facility/Professional Professional Modifier Low / Median / High Price $75.92 / $208.42 / $431.52	Professional		$75.92	$208.42	$431.52
Aetna Facility/Professional Professional Modifier 50 Low / Median / High Price $630.38 / $630.38 / $630.38	Professional	50	$630.38	$630.38	$630.38
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $1,139.00 / $2,479.00 / $4,441.52	Facility		$1,139.00	$2,479.00	$4,441.52
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $107.27 / $206.66 / $484.36	Professional		$107.27	$206.66	$484.36
Anthem BCBS Facility/Professional Professional Modifier 50 Low / Median / High Price $180.10 / $309.99 / $726.54	Professional	50	$180.10	$309.99	$726.54
Cigna Facility/Professional Facility Modifier Low / Median / High Price $602.85 / $704.48 / $1,080.69	Facility		$602.85	$704.48	$1,080.69
Cigna Facility/Professional Professional Modifier Low / Median / High Price $150.69 / $363.73 / $994.68	Professional		$150.69	$363.73	$994.68
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $75.92 / $190.47 / $375.16	Facility		$75.92	$190.47	$375.16
Medica Facility/Professional Facility Modifier Low / Median / High Price $80.01 / $241.84 / $3,326.00	Facility		$80.01	$241.84	$3,326.00
Medica Facility/Professional Facility Modifier 50 Low / Median / High Price $3,329.10 / $3,329.10 / $3,329.10	Facility	50	$3,329.10	$3,329.10	$3,329.10
Medica Facility/Professional Facility Modifier 52 Low / Median / High Price $447.49 / $447.49 / $893.97	Facility	52	$447.49	$447.49	$893.97
Medica Facility/Professional Professional Modifier Low / Median / High Price $237.28 / $429.75 / $1,594.08	Professional		$237.28	$429.75	$1,594.08
Molina Facility/Professional Professional Modifier Low / Median / High Price $132.62 / $222.38 / $551.40	Professional		$132.62	$222.38	$551.40
Prevea360 Facility/Professional Facility Modifier Low / Median / High Price $75.92 / $190.47 / $336.87	Facility		$75.92	$190.47	$336.87
Quartz Facility/Professional Professional Modifier Low / Median / High Price $183.29 / $344.03 / $707.50	Professional		$183.29	$344.03	$707.50
Quartz Facility/Professional Facility Modifier Low / Median / High Price $373.93 / $373.93 / $763.85	Facility		$373.93	$373.93	$763.85
Quartz Facility/Professional Facility Modifier 52 Low / Median / High Price $299.14 / $299.14 / $299.14	Facility	52	$299.14	$299.14	$299.14
Quartz Facility/Professional Professional Modifier Low / Median / High Price $192.96 / $616.79 / $1,886.00	Professional		$192.96	$616.79	$1,886.00
Security Health Facility/Professional Professional Modifier Low / Median / High Price $286.85 / $479.23 / $1,310.71	Professional		$286.85	$479.23	$1,310.71
United Facility/Professional Facility Modifier Low / Median / High Price $1,957.00 / $3,068.00 / $4,295.00	Facility		$1,957.00	$3,068.00	$4,295.00
United Facility/Professional Professional Modifier Low / Median / High Price $229.26 / $421.48 / $973.32	Professional		$229.26	$421.48	$973.32