Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $754.18 / $1,340.59 / $14,482.00	Facility		$754.18	$1,340.59	$14,482.00
Aetna Facility/Professional Facility Modifier 50 Low / Median / High Price $2,673.20 / $3,894.80 / $8,964.75	Facility	50	$2,673.20	$3,894.80	$8,964.75
Aetna Facility/Professional Professional Modifier Low / Median / High Price $490.84 / $754.18 / $2,457.40	Professional		$490.84	$754.18	$2,457.40
Aetna Facility/Professional Professional Modifier 50 Low / Median / High Price $406.75 / $1,956.10 / $5,465.50	Professional	50	$406.75	$1,956.10	$5,465.50
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 $565.25 / $973.76 / $2,573.46	Professional		$565.25	$973.76	$2,573.46
Anthem BCBS Facility/Professional Professional Modifier 50 Low / Median / High Price $942.09 / $1,489.26 / $3,860.21	Professional	50	$942.09	$1,489.26	$3,860.21
Cigna Facility/Professional Facility Modifier Low / Median / High Price $1,742.77 / $2,036.56 / $3,284.90	Facility		$1,742.77	$2,036.56	$3,284.90
Cigna Facility/Professional Professional Modifier Low / Median / High Price $602.73 / $1,305.90 / $2,797.15	Professional		$602.73	$1,305.90	$2,797.15
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $503.14 / $740.83 / $1,241.55	Facility		$503.14	$740.83	$1,241.55
Medica Facility/Professional Facility Modifier Low / Median / High Price $538.37 / $992.79 / $8,384.00	Facility		$538.37	$992.79	$8,384.00
Medica Facility/Professional Facility Modifier 50 Low / Median / High Price $3,273.91 / $3,273.91 / $72,758.46	Facility	50	$3,273.91	$3,273.91	$72,758.46
Medica Facility/Professional Professional Modifier Low / Median / High Price $659.00 / $1,370.35 / $4,849.92	Professional		$659.00	$1,370.35	$4,849.92
Medica Facility/Professional Professional Modifier 50 Low / Median / High Price $2,675.03 / $2,675.03 / $2,837.03	Professional	50	$2,675.03	$2,675.03	$2,837.03
Molina Facility/Professional Professional Modifier Low / Median / High Price $58.42 / $347.97 / $1,074.08	Professional		$58.42	$347.97	$1,074.08
Prevea360 Facility/Professional Facility Modifier Low / Median / High Price $503.14 / $754.18 / $1,314.88	Facility		$503.14	$754.18	$1,314.88
Quartz Facility/Professional Professional Modifier Low / Median / High Price $978.25 / $1,525.54 / $2,196.25	Professional		$978.25	$1,525.54	$2,196.25
Quartz Facility/Professional Facility Modifier Low / Median / High Price $3,537.66 / $3,537.66 / $3,537.66	Facility		$3,537.66	$3,537.66	$3,537.66
Quartz Facility/Professional Professional Modifier Low / Median / High Price $858.57 / $2,776.86 / $4,849.92	Professional		$858.57	$2,776.86	$4,849.92
Security Health Facility/Professional Professional Modifier Low / Median / High Price $1,882.09 / $4,886.93 / $6,344.47	Professional		$1,882.09	$4,886.93	$6,344.47
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 $648.11 / $1,183.39 / $2,742.26	Professional		$648.11	$1,183.39	$2,742.26