Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $248.83 / $1,894.00 / $6,693.73	Facility		$248.83	$1,894.00	$6,693.73
Aetna Facility/Professional Facility Modifier 50 Low / Median / High Price $1,826.84 / $4,477.28 / $8,514.66	Facility	50	$1,826.84	$4,477.28	$8,514.66
Aetna Facility/Professional Professional Modifier Low / Median / High Price $184.23 / $425.91 / $2,519.67	Professional		$184.23	$425.91	$2,519.67
Aetna Facility/Professional Professional Modifier 50 Low / Median / High Price $272.05 / $1,090.94 / $4,462.50	Professional	50	$272.05	$1,090.94	$4,462.50
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $1,905.00 / $3,496.00 / $5,962.00	Facility		$1,905.00	$3,496.00	$5,962.00
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $281.13 / $435.29 / $1,115.00	Professional		$281.13	$435.29	$1,115.00
Anthem BCBS Facility/Professional Professional Modifier 50 Low / Median / High Price $421.69 / $652.92 / $1,672.50	Professional	50	$421.69	$652.92	$1,672.50
CareSource Facility/Professional Facility Modifier Low / Median / High Price $180.73 / $216.88 / $271.10	Facility		$180.73	$216.88	$271.10
CareSource Facility/Professional Professional Modifier Low / Median / High Price $391.98 / $411.58 / $535.26	Professional		$391.98	$411.58	$535.26
Cigna Facility/Professional Facility Modifier Low / Median / High Price $1,196.69 / $1,398.42 / $2,145.21	Facility		$1,196.69	$1,398.42	$2,145.21
Cigna Facility/Professional Professional Modifier Low / Median / High Price $368.91 / $852.79 / $1,978.35	Professional		$368.91	$852.79	$1,978.35
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $184.23 / $416.25 / $793.58	Facility		$184.23	$416.25	$793.58
Medica Facility/Professional Facility Modifier Low / Median / High Price $207.96 / $487.01 / $6,955.00	Facility		$207.96	$487.01	$6,955.00
Medica Facility/Professional Facility Modifier 50 Low / Median / High Price $2,512.90 / $6,616.80 / $8,232.99	Facility	50	$2,512.90	$6,616.80	$8,232.99
Medica Facility/Professional Professional Modifier Low / Median / High Price $471.80 / $883.71 / $3,113.32	Professional		$471.80	$883.71	$3,113.32
Medica Facility/Professional Professional Modifier 50 Low / Median / High Price $2,235.63 / $2,235.63 / $2,235.63	Professional	50	$2,235.63	$2,235.63	$2,235.63
Molina Facility/Professional Professional Modifier Low / Median / High Price $28.95 / $308.15 / $852.65	Professional		$28.95	$308.15	$852.65
Prevea360 Facility/Professional Facility Modifier Low / Median / High Price $184.23 / $416.25 / $793.58	Facility		$184.23	$416.25	$793.58
Quartz Facility/Professional Professional Modifier Low / Median / High Price $440.08 / $845.00 / $1,461.46	Professional		$440.08	$845.00	$1,461.46
Quartz Facility/Professional Facility Modifier Low / Median / High Price $1,127.34 / $1,127.34 / $1,900.50	Facility		$1,127.34	$1,127.34	$1,900.50
Quartz Facility/Professional Professional Modifier Low / Median / High Price $452.42 / $1,659.61 / $3,287.44	Professional		$452.42	$1,659.61	$3,287.44
Security Health Facility/Professional Professional Modifier Low / Median / High Price $742.76 / $1,123.72 / $2,606.86	Professional		$742.76	$1,123.72	$2,606.86
United Facility/Professional Facility Modifier Low / Median / High Price $4,103.00 / $6,477.00 / $8,384.00	Facility		$4,103.00	$6,477.00	$8,384.00
United Facility/Professional Professional Modifier Low / Median / High Price $448.78 / $807.04 / $1,842.07	Professional		$448.78	$807.04	$1,842.07