Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $396.55 / $4,922.96 / $36,812.50	Facility		$396.55	$4,922.96	$36,812.50
Aetna Facility/Professional Facility Modifier 52 Low / Median / High Price $290.31 / $290.31 / $999.25	Facility	52	$290.31	$290.31	$999.25
Aetna Facility/Professional Facility Modifier 53 Low / Median / High Price $116.12 / $116.12 / $399.70	Facility	53	$116.12	$116.12	$399.70
Aetna Facility/Professional Professional Modifier Low / Median / High Price $530.37 / $851.11 / $3,651.16	Professional		$530.37	$851.11	$3,651.16
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $10,878.00 / $23,264.00 / $38,530.00	Facility		$10,878.00	$23,264.00	$38,530.00
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $550.62 / $1,081.40 / $3,502.73	Professional		$550.62	$1,081.40	$3,502.73
CareSource Facility/Professional Facility Modifier Low / Median / High Price $548.36 / $849.17 / $849.17	Facility		$548.36	$849.17	$849.17
CareSource Facility/Professional Professional Modifier Low / Median / High Price $849.17 / $1,312.57 / $1,312.57	Professional		$849.17	$1,312.57	$1,312.57
Cigna Facility/Professional Facility Modifier Low / Median / High Price $1,400.34 / $1,636.41 / $2,639.47	Facility		$1,400.34	$1,636.41	$2,639.47
Cigna Facility/Professional Professional Modifier Low / Median / High Price $996.76 / $1,544.16 / $2,233.41	Professional		$996.76	$1,544.16	$2,233.41
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $548.22 / $667.42 / $1,084.20	Facility		$548.22	$667.42	$1,084.20
Medica Facility/Professional Facility Modifier Low / Median / High Price $598.05 / $13,982.00 / $24,552.00	Facility		$598.05	$13,982.00	$24,552.00
Medica Facility/Professional Professional Modifier Low / Median / High Price $666.98 / $1,268.27 / $3,242.37	Professional		$666.98	$1,268.27	$3,242.37
Molina Facility/Professional Professional Modifier Low / Median / High Price $85.00 / $776.41 / $1,189.12	Professional		$85.00	$776.41	$1,189.12
Prevea360 Facility/Professional Facility Modifier Low / Median / High Price $548.22 / $667.42 / $1,084.20	Facility		$548.22	$667.42	$1,084.20
Quartz Facility/Professional Professional Modifier Low / Median / High Price $1,191.03 / $1,547.52 / $2,019.95	Professional		$1,191.03	$1,547.52	$2,019.95
Quartz Facility/Professional Facility Modifier Low / Median / High Price $39,670.90 / $39,670.90 / $39,670.90	Facility		$39,670.90	$39,670.90	$39,670.90
Quartz Facility/Professional Facility Modifier 52 Low / Median / High Price $30,081.88 / $30,081.88 / $30,081.88	Facility	52	$30,081.88	$30,081.88	$30,081.88
Quartz Facility/Professional Facility Modifier 53 Low / Median / High Price $7,520.47 / $7,520.47 / $7,520.47	Facility	53	$7,520.47	$7,520.47	$7,520.47
Quartz Facility/Professional Professional Modifier Low / Median / High Price $828.82 / $2,302.29 / $3,571.80	Professional		$828.82	$2,302.29	$3,571.80
Security Health Facility/Professional Facility Modifier Low / Median / High Price $25,543.84 / $29,951.96 / $37,564.47	Facility		$25,543.84	$29,951.96	$37,564.47
Security Health Facility/Professional Professional Modifier Low / Median / High Price $2,546.21 / $3,794.66 / $3,794.66	Professional		$2,546.21	$3,794.66	$3,794.66
United Facility/Professional Facility Modifier Low / Median / High Price $8,627.00 / $14,541.00 / $26,114.00	Facility		$8,627.00	$14,541.00	$26,114.00
United Facility/Professional Professional Modifier Low / Median / High Price $666.98 / $1,210.69 / $2,730.94	Professional		$666.98	$1,210.69	$2,730.94