Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $149.07 / $708.10 / $6,461.00	Facility		$149.07	$708.10	$6,461.00
Aetna Facility/Professional Facility Modifier 50 Low / Median / High Price $1,859.19 / $4,185.77 / $7,294.93	Facility	50	$1,859.19	$4,185.77	$7,294.93
Aetna Facility/Professional Professional Modifier Low / Median / High Price $139.41 / $263.93 / $8,050.54	Professional		$139.41	$263.93	$8,050.54
Aetna Facility/Professional Professional Modifier 50 Low / Median / High Price $475.66 / $914.94 / $3,016.00	Professional	50	$475.66	$914.94	$3,016.00
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $1,905.00 / $3,496.00 / $5,962.00	Facility		$1,905.00	$3,496.00	$5,962.00
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $152.51 / $409.20 / $890.83	Professional		$152.51	$409.20	$890.83
Anthem BCBS Facility/Professional Professional Modifier 50 Low / Median / High Price $228.76 / $624.24 / $1,336.24	Professional	50	$228.76	$624.24	$1,336.24
CareSource Facility/Professional Facility Modifier Low / Median / High Price $149.85 / $222.93 / $222.93	Facility		$149.85	$222.93	$222.93
CareSource Facility/Professional Professional Modifier Low / Median / High Price $152.90 / $222.93 / $344.58	Professional		$152.90	$222.93	$344.58
Cigna Facility/Professional Facility Modifier Low / Median / High Price $423.53 / $494.92 / $798.30	Facility		$423.53	$494.92	$798.30
Cigna Facility/Professional Professional Modifier Low / Median / High Price $226.54 / $464.28 / $674.32	Professional		$226.54	$464.28	$674.32
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $149.07 / $219.56 / $845.40	Facility		$149.07	$219.56	$845.40
Medica Facility/Professional Facility Modifier Low / Median / High Price $161.77 / $2,586.00 / $6,312.00	Facility		$161.77	$2,586.00	$6,312.00
Medica Facility/Professional Facility Modifier 50 Low / Median / High Price $1,444.12 / $2,428.15 / $3,969.60	Facility	50	$1,444.12	$2,428.15	$3,969.60
Medica Facility/Professional Professional Modifier Low / Median / High Price $178.21 / $377.00 / $1,429.86	Professional		$178.21	$377.00	$1,429.86
Molina Facility/Professional Professional Modifier Low / Median / High Price $81.87 / $224.60 / $370.26	Professional		$81.87	$224.60	$370.26
Prevea360 Facility/Professional Facility Modifier Low / Median / High Price $149.07 / $260.75 / $845.40	Facility		$149.07	$260.75	$845.40
Quartz Facility/Professional Professional Modifier Low / Median / High Price $315.25 / $485.00 / $573.41	Professional		$315.25	$485.00	$573.41
Quartz Facility/Professional Facility Modifier Low / Median / High Price $3,728.65 / $3,728.65 / $3,728.65	Facility		$3,728.65	$3,728.65	$3,728.65
Quartz Facility/Professional Professional Modifier Low / Median / High Price $225.02 / $754.00 / $1,429.86	Professional		$225.02	$754.00	$1,429.86
Security Health Facility/Professional Professional Modifier Low / Median / High Price $533.21 / $906.87 / $906.87	Professional		$533.21	$906.87	$906.87
United Facility/Professional Facility Modifier Low / Median / High Price $2,960.00 / $4,155.00 / $5,865.00	Facility		$2,960.00	$4,155.00	$5,865.00
United Facility/Professional Professional Modifier Low / Median / High Price $165.77 / $421.39 / $737.91	Professional		$165.77	$421.39	$737.91