Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $324.31 / $794.78 / $2,050.11	Facility		$324.31	$794.78	$2,050.11
Aetna Facility/Professional Facility Modifier 50 Low / Median / High Price $6,766.30 / $6,766.30 / $6,766.30	Facility	50	$6,766.30	$6,766.30	$6,766.30
Aetna Facility/Professional Professional Modifier Low / Median / High Price $231.83 / $454.32 / $1,263.00	Professional		$231.83	$454.32	$1,263.00
Aetna Facility/Professional Professional Modifier 50 Low / Median / High Price $639.87 / $681.48 / $5,268.09	Professional	50	$639.87	$681.48	$5,268.09
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 $318.14 / $517.92 / $1,908.84	Professional		$318.14	$517.92	$1,908.84
Anthem BCBS Facility/Professional Professional Modifier 50 Low / Median / High Price $477.22 / $776.89 / $2,897.24	Professional	50	$477.22	$776.89	$2,897.24
CareSource Facility/Professional Facility Modifier Low / Median / High Price $263.27 / $263.27 / $263.27	Facility		$263.27	$263.27	$263.27
CareSource Facility/Professional Professional Modifier Low / Median / High Price $218.88 / $229.82 / $301.14	Professional		$218.88	$229.82	$301.14
Cigna Facility/Professional Facility Modifier Low / Median / High Price $651.51 / $761.34 / $1,228.02	Facility		$651.51	$761.34	$1,228.02
Cigna Facility/Professional Professional Modifier Low / Median / High Price $289.19 / $569.34 / $1,183.04	Professional		$289.19	$569.34	$1,183.04
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $231.83 / $376.11 / $966.21	Facility		$231.83	$376.11	$966.21
Medica Facility/Professional Facility Modifier Low / Median / High Price $237.84 / $682.61 / $4,130.00	Facility		$237.84	$682.61	$4,130.00
Medica Facility/Professional Professional Modifier Low / Median / High Price $503.36 / $1,056.83 / $2,946.00	Professional		$503.36	$1,056.83	$2,946.00
Molina Facility/Professional Professional Modifier Low / Median / High Price $123.44 / $200.27 / $489.96	Professional		$123.44	$200.27	$489.96
Prevea360 Facility/Professional Facility Modifier Low / Median / High Price $231.83 / $389.17 / $1,023.51	Facility		$231.83	$389.17	$1,023.51
Quartz Facility/Professional Professional Modifier Low / Median / High Price $417.30 / $569.51 / $853.62	Professional		$417.30	$569.51	$853.62
Quartz Facility/Professional Facility Modifier Low / Median / High Price $1,774.57 / $1,774.57 / $1,774.57	Facility		$1,774.57	$1,774.57	$1,774.57
Quartz Facility/Professional Professional Modifier Low / Median / High Price $409.85 / $2,244.64 / $2,946.00	Professional		$409.85	$2,244.64	$2,946.00
Security Health Facility/Professional Professional Modifier Low / Median / High Price $1,932.70 / $2,247.17 / $2,699.02	Professional		$1,932.70	$2,247.17	$2,699.02
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 $430.38 / $1,026.59 / $2,247.30	Professional		$430.38	$1,026.59	$2,247.30