Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $3,226.41 / $61,405.96 / $72,421.34	Facility		$3,226.41	$61,405.96	$72,421.34
Aetna Facility/Professional Facility Modifier 53 Low / Median / High Price $339.62 / $339.62 / $645.28	Facility	53	$339.62	$339.62	$645.28
Aetna Facility/Professional Professional Modifier Low / Median / High Price $895.98 / $1,336.72 / $6,966.41	Professional		$895.98	$1,336.72	$6,966.41
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $17,395.00 / $25,100.00 / $52,845.00	Facility		$17,395.00	$25,100.00	$52,845.00
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $1,052.83 / $1,949.12 / $7,227.14	Professional		$1,052.83	$1,949.12	$7,227.14
CareSource Facility/Professional Facility Modifier Low / Median / High Price $880.82 / $1,360.26 / $1,360.26	Facility		$880.82	$1,360.26	$1,360.26
CareSource Facility/Professional Professional Modifier Low / Median / High Price $1,360.26 / $2,102.55 / $2,102.55	Professional		$1,360.26	$2,102.55	$2,102.55
Cigna Facility/Professional Facility Modifier Low / Median / High Price $2,266.32 / $2,648.37 / $4,271.72	Facility		$2,266.32	$2,648.37	$4,271.72
Cigna Facility/Professional Professional Modifier Low / Median / High Price $1,609.17 / $2,492.38 / $3,610.67	Professional		$1,609.17	$2,492.38	$3,610.67
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $885.05 / $1,240.51 / $1,754.31	Facility		$885.05	$1,240.51	$1,754.31
Medica Facility/Professional Facility Modifier Low / Median / High Price $965.51 / $18,562.00 / $35,690.87	Facility		$965.51	$18,562.00	$35,690.87
Medica Facility/Professional Professional Modifier Low / Median / High Price $1,269.31 / $3,510.84 / $5,919.20	Professional		$1,269.31	$3,510.84	$5,919.20
Molina Facility/Professional Professional Modifier Low / Median / High Price $85.00 / $1,412.31 / $1,984.71	Professional		$85.00	$1,412.31	$1,984.71
Prevea360 Facility/Professional Facility Modifier Low / Median / High Price $885.05 / $1,240.51 / $1,754.31	Facility		$885.05	$1,240.51	$1,754.31
Quartz Facility/Professional Professional Modifier Low / Median / High Price $2,114.19 / $2,492.58 / $3,674.77	Professional		$2,114.19	$2,492.58	$3,674.77
Quartz Facility/Professional Facility Modifier Low / Median / High Price $26,727.00 / $26,727.00 / $26,727.00	Facility		$26,727.00	$26,727.00	$26,727.00
Quartz Facility/Professional Facility Modifier 53 Low / Median / High Price $5,345.40 / $5,345.40 / $5,345.40	Facility	53	$5,345.40	$5,345.40	$5,345.40
Quartz Facility/Professional Professional Modifier Low / Median / High Price $1,337.77 / $3,716.06 / $6,806.64	Professional		$1,337.77	$3,716.06	$6,806.64
Security Health Facility/Professional Facility Modifier Low / Median / High Price $35,066.75 / $40,397.19 / $51,568.75	Facility		$35,066.75	$40,397.19	$51,568.75
Security Health Facility/Professional Professional Modifier Low / Median / High Price $3,794.32 / $5,905.17 / $5,905.17	Professional		$3,794.32	$5,905.17	$5,905.17
United Facility/Professional Facility Modifier Low / Median / High Price $9,596.00 / $19,304.00 / $37,141.00	Facility		$9,596.00	$19,304.00	$37,141.00
United Facility/Professional Professional Modifier Low / Median / High Price $1,177.24 / $3,195.07 / $5,168.72	Professional		$1,177.24	$3,195.07	$5,168.72