Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $180.70 / $724.49 / $14,482.00	Facility		$180.70	$724.49	$14,482.00
Aetna Facility/Professional Professional Modifier Low / Median / High Price $180.70 / $445.08 / $967.88	Professional		$180.70	$445.08	$967.88
Aetna Facility/Professional Professional Modifier 50 Low / Median / High Price $482.32 / $482.32 / $482.32	Professional	50	$482.32	$482.32	$482.32
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $1,905.00 / $3,300.00 / $5,962.00	Facility		$1,905.00	$3,300.00	$5,962.00
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $250.23 / $483.39 / $1,190.43	Professional		$250.23	$483.39	$1,190.43
Anthem BCBS Facility/Professional Professional Modifier 50 Low / Median / High Price $428.70 / $739.58 / $1,876.13	Professional	50	$428.70	$739.58	$1,876.13
Cigna Facility/Professional Facility Modifier Low / Median / High Price $1,282.29 / $1,498.46 / $2,298.67	Facility		$1,282.29	$1,498.46	$2,298.67
Cigna Facility/Professional Professional Modifier Low / Median / High Price $361.34 / $866.71 / $2,118.17	Professional		$361.34	$866.71	$2,118.17
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $187.02 / $430.17 / $804.42	Facility		$187.02	$430.17	$804.42
Medica Facility/Professional Facility Modifier Low / Median / High Price $229.64 / $4,993.13 / $8,384.00	Facility		$229.64	$4,993.13	$8,384.00
Medica Facility/Professional Facility Modifier 50 Low / Median / High Price $4,348.80 / $4,348.80 / $4,348.80	Facility	50	$4,348.80	$4,348.80	$4,348.80
Medica Facility/Professional Professional Modifier Low / Median / High Price $562.38 / $1,467.04 / $3,728.70	Professional		$562.38	$1,467.04	$3,728.70
Molina Facility/Professional Professional Modifier Low / Median / High Price $30.95 / $345.60 / $866.94	Professional		$30.95	$345.60	$866.94
Prevea360 Facility/Professional Facility Modifier Low / Median / High Price $187.02 / $430.17 / $860.34	Facility		$187.02	$430.17	$860.34
Quartz Facility/Professional Professional Modifier Low / Median / High Price $431.46 / $713.50 / $1,535.60	Professional		$431.46	$713.50	$1,535.60
Quartz Facility/Professional Facility Modifier Low / Median / High Price $1,374.36 / $1,374.36 / $1,374.36	Facility		$1,374.36	$1,374.36	$1,374.36
Quartz Facility/Professional Professional Modifier Low / Median / High Price $498.14 / $1,467.04 / $4,207.00	Professional		$498.14	$1,467.04	$4,207.00
Security Health Facility/Professional Professional Modifier Low / Median / High Price $695.13 / $1,142.11 / $2,791.14	Professional		$695.13	$1,142.11	$2,791.14
United Facility/Professional Facility Modifier Low / Median / High Price $4,918.00 / $7,280.00 / $8,384.00	Facility		$4,918.00	$7,280.00	$8,384.00
United Facility/Professional Professional Modifier Low / Median / High Price $551.57 / $1,449.84 / $2,276.39	Professional		$551.57	$1,449.84	$2,276.39