Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $690.26 / $953.44 / $14,482.00	Facility		$690.26	$953.44	$14,482.00
Aetna Facility/Professional Facility Modifier 50 Low / Median / High Price $0.95 / $0.95 / $0.95	Facility	50	$0.95	$0.95	$0.95
Aetna Facility/Professional Professional Modifier Low / Median / High Price $481.85 / $690.26 / $2,012.66	Professional		$481.85	$690.26	$2,012.66
Aetna Facility/Professional Professional Modifier 50 Low / Median / High Price $481.90 / $481.90 / $1,104.56	Professional	50	$481.90	$481.90	$1,104.56
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 $507.41 / $891.21 / $2,342.88	Professional		$507.41	$891.21	$2,342.88
Anthem BCBS Facility/Professional Professional Modifier 50 Low / Median / High Price $845.68 / $1,363.03 / $3,514.32	Professional	50	$845.68	$1,363.03	$3,514.32
Cigna Facility/Professional Facility Modifier Low / Median / High Price $1,567.95 / $1,832.27 / $2,955.39	Facility		$1,567.95	$1,832.27	$2,955.39
Cigna Facility/Professional Professional Modifier Low / Median / High Price $540.82 / $1,185.10 / $2,814.99	Professional		$540.82	$1,185.10	$2,814.99
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $508.50 / $690.26 / $1,200.13	Facility		$508.50	$690.26	$1,200.13
Medica Facility/Professional Facility Modifier Low / Median / High Price $508.50 / $901.33 / $8,384.00	Facility		$508.50	$901.33	$8,384.00
Medica Facility/Professional Professional Modifier Low / Median / High Price $560.89 / $1,146.89 / $4,805.00	Professional		$560.89	$1,146.89	$4,805.00
Molina Facility/Professional Professional Modifier Low / Median / High Price $58.42 / $320.47 / $978.94	Professional		$58.42	$320.47	$978.94
Prevea360 Facility/Professional Facility Modifier Low / Median / High Price $508.50 / $709.86 / $1,259.13	Facility		$508.50	$709.86	$1,259.13
Quartz Facility/Professional Professional Modifier Low / Median / High Price $894.40 / $1,368.57 / $1,970.27	Professional		$894.40	$1,368.57	$1,970.27
Quartz Facility/Professional Facility Modifier Low / Median / High Price $3,237.72 / $3,237.72 / $3,237.72	Facility		$3,237.72	$3,237.72	$3,237.72
Quartz Facility/Professional Professional Modifier Low / Median / High Price $723.98 / $2,240.75 / $4,805.00	Professional		$723.98	$2,240.75	$4,805.00
Security Health Facility/Professional Professional Modifier Low / Median / High Price $1,961.12 / $4,476.91 / $5,705.22	Professional		$1,961.12	$4,476.91	$5,705.22
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 $560.89 / $1,083.92 / $2,463.84	Professional		$560.89	$1,083.92	$2,463.84