Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $177.43 / $1,826.84 / $3,838.04	Facility		$177.43	$1,826.84	$3,838.04
Aetna Facility/Professional Facility Modifier 50 Low / Median / High Price $1,894.00 / $3,111.33 / $8,364.36	Facility	50	$1,894.00	$3,111.33	$8,364.36
Aetna Facility/Professional Professional Modifier Low / Median / High Price $183.00 / $414.81 / $1,413.31	Professional		$183.00	$414.81	$1,413.31
Aetna Facility/Professional Professional Modifier 50 Low / Median / High Price $315.20 / $1,088.34 / $3,672.21	Professional	50	$315.20	$1,088.34	$3,672.21
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $1,183.00 / $3,483.00 / $5,962.00	Facility		$1,183.00	$3,483.00	$5,962.00
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $280.63 / $434.52 / $1,130.13	Professional		$280.63	$434.52	$1,130.13
Anthem BCBS Facility/Professional Professional Modifier 50 Low / Median / High Price $420.94 / $651.78 / $1,695.19	Professional	50	$420.94	$651.78	$1,695.19
CareSource Facility/Professional Facility Modifier Low / Median / High Price $180.77 / $216.92 / $271.16	Facility		$180.77	$216.92	$271.16
CareSource Facility/Professional Professional Modifier Low / Median / High Price $388.56 / $407.99 / $530.91	Professional		$388.56	$407.99	$530.91
Cigna Facility/Professional Facility Modifier Low / Median / High Price $1,186.78 / $1,386.84 / $2,127.44	Facility		$1,186.78	$1,386.84	$2,127.44
Cigna Facility/Professional Professional Modifier Low / Median / High Price $368.49 / $826.93 / $1,961.84	Professional		$368.49	$826.93	$1,961.84
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $183.92 / $412.47 / $802.59	Facility		$183.92	$412.47	$802.59
Medica Facility/Professional Facility Modifier Low / Median / High Price $207.59 / $482.59 / $6,955.00	Facility		$207.59	$482.59	$6,955.00
Medica Facility/Professional Facility Modifier 50 Low / Median / High Price $2,417.31 / $7,355.48 / $8,086.81	Facility	50	$2,417.31	$7,355.48	$8,086.81
Medica Facility/Professional Professional Modifier Low / Median / High Price $476.72 / $892.71 / $3,145.03	Professional		$476.72	$892.71	$3,145.03
Molina Facility/Professional Professional Modifier Low / Median / High Price $30.95 / $316.32 / $840.50	Professional		$30.95	$316.32	$840.50
Prevea360 Facility/Professional Facility Modifier Low / Median / High Price $183.92 / $412.47 / $802.59	Facility		$183.92	$412.47	$802.59
Quartz Facility/Professional Professional Modifier Low / Median / High Price $440.08 / $837.85 / $1,449.09	Professional		$440.08	$837.85	$1,449.09
Quartz Facility/Professional Facility Modifier Low / Median / High Price $1,125.34 / $1,125.34 / $1,900.50	Facility		$1,125.34	$1,125.34	$1,900.50
Quartz Facility/Professional Professional Modifier Low / Median / High Price $451.62 / $1,646.13 / $3,260.40	Professional		$451.62	$1,646.13	$3,260.40
Security Health Facility/Professional Professional Modifier Low / Median / High Price $742.76 / $1,121.76 / $2,585.17	Professional		$742.76	$1,121.76	$2,585.17
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 $465.41 / $847.87 / $1,846.56	Professional		$465.41	$847.87	$1,846.56