Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $453.04 / $624.65 / $1,894.00	Facility		$453.04	$624.65	$1,894.00
Aetna Facility/Professional Facility Modifier 50 Low / Median / High Price $3,716.70 / $4,477.00 / $4,477.00	Facility	50	$3,716.70	$4,477.00	$4,477.00
Aetna Facility/Professional Professional Modifier Low / Median / High Price $453.04 / $986.81 / $1,809.38	Professional		$453.04	$986.81	$1,809.38
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 $335.35 / $688.16 / $2,234.84	Professional		$335.35	$688.16	$2,234.84
Anthem BCBS Facility/Professional Professional Modifier 50 Low / Median / High Price $503.02 / $894.61 / $3,363.84	Professional	50	$503.02	$894.61	$3,363.84
CareSource Facility/Professional Facility Modifier Low / Median / High Price $370.63 / $370.63 / $370.63	Facility		$370.63	$370.63	$370.63
CareSource Facility/Professional Professional Modifier Low / Median / High Price $306.45 / $321.77 / $424.96	Professional		$306.45	$321.77	$424.96
Cigna Facility/Professional Facility Modifier Low / Median / High Price $901.12 / $1,053.03 / $1,698.50	Facility		$901.12	$1,053.03	$1,698.50
Cigna Facility/Professional Professional Modifier Low / Median / High Price $364.27 / $731.78 / $1,653.78	Professional		$364.27	$731.78	$1,653.78
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $327.14 / $497.18 / $1,132.59	Facility		$327.14	$497.18	$1,132.59
Medica Facility/Professional Facility Modifier Low / Median / High Price $333.14 / $843.37 / $4,130.00	Facility		$333.14	$843.37	$4,130.00
Medica Facility/Professional Professional Modifier Low / Median / High Price $390.83 / $1,222.64 / $5,265.22	Professional		$390.83	$1,222.64	$5,265.22
Molina Facility/Professional Professional Modifier Low / Median / High Price $26.31 / $215.22 / $592.66	Professional		$26.31	$215.22	$592.66
Prevea360 Facility/Professional Facility Modifier Low / Median / High Price $327.14 / $509.50 / $1,186.81	Facility		$327.14	$509.50	$1,186.81
Quartz Facility/Professional Professional Modifier Low / Median / High Price $585.00 / $794.32 / $1,143.55	Professional		$585.00	$794.32	$1,143.55
Quartz Facility/Professional Facility Modifier Low / Median / High Price $2,470.44 / $2,470.44 / $2,470.44	Facility		$2,470.44	$2,470.44	$2,470.44
Quartz Facility/Professional Professional Modifier Low / Median / High Price $570.12 / $1,483.75 / $5,265.22	Professional		$570.12	$1,483.75	$5,265.22
Security Health Facility/Professional Professional Modifier Low / Median / High Price $1,535.83 / $2,930.85 / $3,300.95	Professional		$1,535.83	$2,930.85	$3,300.95
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 $383.89 / $928.85 / $1,830.43	Professional		$383.89	$928.85	$1,830.43