Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $120.62 / $1,620.15 / $4,520.64	Facility		$120.62	$1,620.15	$4,520.64
Aetna Facility/Professional Facility Modifier 50 Low / Median / High Price $2,852.11 / $3,111.11 / $9,041.28	Facility	50	$2,852.11	$3,111.11	$9,041.28
Aetna Facility/Professional Professional Modifier Low / Median / High Price $120.62 / $254.28 / $1,368.35	Professional		$120.62	$254.28	$1,368.35
Aetna Facility/Professional Professional Modifier 50 Low / Median / High Price $171.84 / $288.25 / $3,056.40	Professional	50	$171.84	$288.25	$3,056.40
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 $162.16 / $295.39 / $751.60	Professional		$162.16	$295.39	$751.60
Anthem BCBS Facility/Professional Professional Modifier 50 Low / Median / High Price $256.20 / $443.08 / $1,127.40	Professional	50	$256.20	$443.08	$1,127.40
Cigna Facility/Professional Facility Modifier Low / Median / High Price $718.19 / $839.26 / $1,287.45	Facility		$718.19	$839.26	$1,287.45
Cigna Facility/Professional Professional Modifier Low / Median / High Price $240.22 / $518.64 / $1,190.83	Professional		$240.22	$518.64	$1,190.83
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $120.28 / $249.34 / $469.78	Facility		$120.28	$249.34	$469.78
Medica Facility/Professional Facility Modifier Low / Median / High Price $120.62 / $276.62 / $2,930.60	Facility		$120.62	$276.62	$2,930.60
Medica Facility/Professional Facility Modifier 50 Low / Median / High Price $2,768.85 / $2,768.85 / $2,768.85	Facility	50	$2,768.85	$2,768.85	$2,768.85
Medica Facility/Professional Professional Modifier Low / Median / High Price $289.79 / $626.83 / $1,990.16	Professional		$289.79	$626.83	$1,990.16
Medica Facility/Professional Professional Modifier 50 Low / Median / High Price $417.68 / $417.68 / $417.68	Professional	50	$417.68	$417.68	$417.68
Molina Facility/Professional Professional Modifier Low / Median / High Price $134.13 / $244.10 / $551.40	Professional		$134.13	$244.10	$551.40
Prevea360 Facility/Professional Facility Modifier Low / Median / High Price $120.28 / $249.34 / $469.78	Facility		$120.28	$249.34	$469.78
Quartz Facility/Professional Professional Modifier Low / Median / High Price $298.98 / $546.54 / $890.37	Professional		$298.98	$546.54	$890.37
Quartz Facility/Professional Facility Modifier Low / Median / High Price $593.41 / $593.41 / $982.04	Facility		$593.41	$593.41	$982.04
Quartz Facility/Professional Professional Modifier Low / Median / High Price $306.56 / $1,139.00 / $1,990.16	Professional		$306.56	$1,139.00	$1,990.16
Security Health Facility/Professional Professional Modifier Low / Median / High Price $441.79 / $761.46 / $1,569.17	Professional		$441.79	$761.46	$1,569.17
United Facility/Professional Facility Modifier Low / Median / High Price $2,367.00 / $3,088.30 / $4,295.00	Facility		$2,367.00	$3,088.30	$4,295.00
United Facility/Professional Professional Modifier Low / Median / High Price $275.11 / $515.59 / $1,122.90	Professional		$275.11	$515.59	$1,122.90