Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $910.04 / $4,825.14 / $10,294.75	Facility		$910.04	$4,825.14	$10,294.75
Aetna Facility/Professional Facility Modifier 50 Low / Median / High Price $4,230.72 / $5,949.80 / $11,838.78	Facility	50	$4,230.72	$5,949.80	$11,838.78
Aetna Facility/Professional Professional Modifier Low / Median / High Price $394.44 / $864.64 / $3,759.91	Professional		$394.44	$864.64	$3,759.91
Aetna Facility/Professional Professional Modifier 50 Low / Median / High Price $206.57 / $1,805.43 / $7,446.00	Professional	50	$206.57	$1,805.43	$7,446.00
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $2,740.00 / $4,780.00 / $7,344.00	Facility		$2,740.00	$4,780.00	$7,344.00
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $415.11 / $963.82 / $2,471.98	Professional		$415.11	$963.82	$2,471.98
Anthem BCBS Facility/Professional Professional Modifier 50 Low / Median / High Price $622.66 / $1,484.86 / $3,707.99	Professional	50	$622.66	$1,484.86	$3,707.99
CareSource Facility/Professional Facility Modifier Low / Median / High Price $415.73 / $498.88 / $623.60	Facility		$415.73	$498.88	$623.60
CareSource Facility/Professional Professional Modifier Low / Median / High Price $407.72 / $428.11 / $574.17	Professional		$407.72	$428.11	$574.17
Cigna Facility/Professional Facility Modifier Low / Median / High Price $1,178.67 / $1,377.36 / $2,112.91	Facility		$1,178.67	$1,377.36	$2,112.91
Cigna Facility/Professional Professional Modifier Low / Median / High Price $626.13 / $1,310.09 / $1,972.75	Professional		$626.13	$1,310.09	$1,972.75
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $404.46 / $574.88 / $919.45	Facility		$404.46	$574.88	$919.45
Medica Facility/Professional Facility Modifier Low / Median / High Price $411.78 / $727.58 / $6,055.00	Facility		$411.78	$727.58	$6,055.00
Medica Facility/Professional Facility Modifier 50 Low / Median / High Price $3,865.50 / $3,865.50 / $4,430.05	Facility	50	$3,865.50	$3,865.50	$4,430.05
Medica Facility/Professional Professional Modifier Low / Median / High Price $463.56 / $1,111.23 / $4,131.06	Professional		$463.56	$1,111.23	$4,131.06
Medica Facility/Professional Professional Modifier 50 Low / Median / High Price $5,669.40 / $5,669.40 / $6,112.97	Professional	50	$5,669.40	$5,669.40	$6,112.97
Molina Facility/Professional Professional Modifier Low / Median / High Price $62.75 / $369.20 / $982.10	Professional		$62.75	$369.20	$982.10
Prevea360 Facility/Professional Facility Modifier Low / Median / High Price $404.46 / $572.12 / $919.45	Facility		$404.46	$572.12	$919.45
Quartz Facility/Professional Professional Modifier Low / Median / High Price $891.80 / $1,097.86 / $1,622.12	Professional		$891.80	$1,097.86	$1,622.12
Quartz Facility/Professional Facility Modifier Low / Median / High Price $1,900.50 / $1,900.50 / $2,079.40	Facility		$1,900.50	$1,900.50	$2,079.40
Quartz Facility/Professional Professional Modifier Low / Median / High Price $872.17 / $2,055.44 / $4,131.06	Professional		$872.17	$2,055.44	$4,131.06
Security Health Facility/Professional Professional Modifier Low / Median / High Price $1,485.58 / $2,554.11 / $2,599.55	Professional		$1,485.58	$2,554.11	$2,599.55
Security Health Facility/Professional Professional Modifier 50 Low / Median / High Price $5,250.00 / $5,250.00 / $5,250.00	Professional	50	$5,250.00	$5,250.00	$5,250.00
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 $408.61 / $1,367.19 / $2,791.27	Professional		$408.61	$1,367.19	$2,791.27