Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $647.73 / $1,115.33 / $8,243.00	Facility		$647.73	$1,115.33	$8,243.00
Aetna Facility/Professional Facility Modifier 50 Low / Median / High Price $5,855.20 / $5,855.20 / $5,855.20	Facility	50	$5,855.20	$5,855.20	$5,855.20
Aetna Facility/Professional Professional Modifier Low / Median / High Price $414.57 / $647.73 / $2,076.27	Professional		$414.57	$647.73	$2,076.27
Aetna Facility/Professional Professional Modifier 50 Low / Median / High Price $78.04 / $780.44 / $6,309.12	Professional	50	$78.04	$780.44	$6,309.12
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 $439.31 / $836.31 / $2,146.16	Professional		$439.31	$836.31	$2,146.16
Anthem BCBS Facility/Professional Professional Modifier 50 Low / Median / High Price $732.19 / $1,279.07 / $3,219.25	Professional	50	$732.19	$1,279.07	$3,219.25
Cigna Facility/Professional Facility Modifier Low / Median / High Price $1,457.11 / $1,702.75 / $2,746.47	Facility		$1,457.11	$1,702.75	$2,746.47
Cigna Facility/Professional Professional Modifier Low / Median / High Price $499.89 / $1,113.86 / $2,612.76	Professional		$499.89	$1,113.86	$2,612.76
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $476.35 / $657.39 / $984.20	Facility		$476.35	$657.39	$984.20
Medica Facility/Professional Facility Modifier Low / Median / High Price $476.35 / $827.16 / $8,384.00	Facility		$476.35	$827.16	$8,384.00
Medica Facility/Professional Facility Modifier 50 Low / Median / High Price $2,776.80 / $2,776.80 / $2,776.80	Facility	50	$2,776.80	$2,776.80	$2,776.80
Medica Facility/Professional Professional Modifier Low / Median / High Price $497.55 / $1,055.25 / $5,606.00	Professional		$497.55	$1,055.25	$5,606.00
Medica Facility/Professional Professional Modifier 50 Low / Median / High Price $5,544.45 / $5,544.45 / $5,575.82	Professional	50	$5,544.45	$5,544.45	$5,575.82
Molina Facility/Professional Professional Modifier Low / Median / High Price $58.42 / $288.49 / $834.32	Professional		$58.42	$288.49	$834.32
Prevea360 Facility/Professional Facility Modifier Low / Median / High Price $476.35 / $657.39 / $1,113.70	Facility		$476.35	$657.39	$1,113.70
Quartz Facility/Professional Professional Modifier Low / Median / High Price $835.90 / $1,266.02 / $1,822.64	Professional		$835.90	$1,266.02	$1,822.64
Quartz Facility/Professional Facility Modifier Low / Median / High Price $3,033.24 / $3,033.24 / $3,033.24	Facility		$3,033.24	$3,033.24	$3,033.24
Quartz Facility/Professional Professional Modifier Low / Median / High Price $675.38 / $2,076.15 / $5,606.00	Professional		$675.38	$2,076.15	$5,606.00
Security Health Facility/Professional Professional Modifier Low / Median / High Price $1,932.70 / $4,202.12 / $5,296.03	Professional		$1,932.70	$4,202.12	$5,296.03
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 $507.09 / $1,022.45 / $2,196.51	Professional		$507.09	$1,022.45	$2,196.51