Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $1,871.02 / $3,374.39 / $7,054.04	Facility		$1,871.02	$3,374.39	$7,054.04
Aetna Facility/Professional Facility Modifier 52 Low / Median / High Price $81.26 / $81.26 / $154.19	Facility	52	$81.26	$81.26	$154.19
Aetna Facility/Professional Facility Modifier 53 Low / Median / High Price $32.50 / $61.68 / $154.09	Facility	53	$32.50	$61.68	$154.09
Aetna Facility/Professional Professional Modifier Low / Median / High Price $165.57 / $334.76 / $2,490.50	Professional		$165.57	$334.76	$2,490.50
Aetna Facility/Professional Professional Modifier 53 Low / Median / High Price $35.65 / $81.31 / $194.41	Professional	53	$35.65	$81.31	$194.41
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $1,139.00 / $2,419.00 / $4,441.52	Facility		$1,139.00	$2,419.00	$4,441.52
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $171.06 / $478.01 / $1,776.65	Professional		$171.06	$478.01	$1,776.65
Anthem BCBS Facility/Professional Professional Modifier 53 Low / Median / High Price $85.58 / $286.08 / $873.99	Professional	53	$85.58	$286.08	$873.99
CareSource Facility/Professional Facility Modifier Low / Median / High Price $23.82 / $165.74 / $261.50	Facility		$23.82	$165.74	$261.50
CareSource Facility/Professional Professional Modifier Low / Median / High Price $41.86 / $227.99 / $463.74	Professional		$41.86	$227.99	$463.74
Cigna Facility/Professional Facility Modifier Low / Median / High Price $906.53 / $1,059.34 / $1,625.07	Facility		$906.53	$1,059.34	$1,625.07
Cigna Facility/Professional Facility Modifier 52 Low / Median / High Price $194.94 / $194.94 / $194.94	Facility	52	$194.94	$194.94	$194.94
Cigna Facility/Professional Facility Modifier 53 Low / Median / High Price $48.74 / $48.74 / $48.74	Facility	53	$48.74	$48.74	$48.74
Cigna Facility/Professional Professional Modifier Low / Median / High Price $244.69 / $468.28 / $1,241.16	Professional		$244.69	$468.28	$1,241.16
Cigna Facility/Professional Professional Modifier 53 Low / Median / High Price $133.43 / $246.00 / $656.57	Professional	53	$133.43	$246.00	$656.57
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $165.57 / $308.39 / $439.63	Facility		$165.57	$308.39	$439.63
DeanCare Facility/Professional Professional Modifier Low / Median / High Price $277.50 / $277.50 / $277.50	Professional		$277.50	$277.50	$277.50
Medica Facility/Professional Facility Modifier Low / Median / High Price $165.58 / $318.35 / $2,903.60	Facility		$165.58	$318.35	$2,903.60
Medica Facility/Professional Facility Modifier 52 Low / Median / High Price $664.86 / $664.86 / $664.86	Facility	52	$664.86	$664.86	$664.86
Medica Facility/Professional Facility Modifier 53 Low / Median / High Price $166.21 / $166.21 / $166.21	Facility	53	$166.21	$166.21	$166.21
Medica Facility/Professional Professional Modifier Low / Median / High Price $359.08 / $1,016.63 / $2,208.13	Professional		$359.08	$1,016.63	$2,208.13
Molina Facility/Professional Professional Modifier Low / Median / High Price $102.76 / $274.03 / $588.93	Professional		$102.76	$274.03	$588.93
Prevea360 Facility/Professional Facility Modifier Low / Median / High Price $165.57 / $308.39 / $433.31	Facility		$165.57	$308.39	$433.31
Prevea360 Facility/Professional Professional Modifier Low / Median / High Price $277.50 / $277.50 / $277.50	Professional		$277.50	$277.50	$277.50
Quartz Facility/Professional Professional Modifier Low / Median / High Price $379.80 / $694.39 / $1,137.40	Professional		$379.80	$694.39	$1,137.40
Quartz Facility/Professional Facility Modifier Low / Median / High Price $243.68 / $1,065.09 / $1,065.09	Facility		$243.68	$1,065.09	$1,065.09
Quartz Facility/Professional Facility Modifier 52 Low / Median / High Price $194.94 / $664.86 / $664.86	Facility	52	$194.94	$664.86	$664.86
Quartz Facility/Professional Facility Modifier 53 Low / Median / High Price $48.74 / $166.21 / $166.21	Facility	53	$48.74	$166.21	$166.21
Quartz Facility/Professional Professional Modifier Low / Median / High Price $301.75 / $1,182.76 / $2,208.13	Professional		$301.75	$1,182.76	$2,208.13
Quartz Facility/Professional Professional Modifier 53 Low / Median / High Price $346.42 / $346.42 / $656.57	Professional	53	$346.42	$346.42	$656.57
Security Health Facility/Professional Professional Modifier Low / Median / High Price $476.20 / $911.11 / $1,722.14	Professional		$476.20	$911.11	$1,722.14
Security Health Facility/Professional Professional Modifier 53 Low / Median / High Price $143.75 / $237.97 / $515.13	Professional	53	$143.75	$237.97	$515.13
United Facility/Professional Facility Modifier Low / Median / High Price $2,367.00 / $2,910.00 / $4,155.00	Facility		$2,367.00	$2,910.00	$4,155.00
United Facility/Professional Professional Modifier Low / Median / High Price $341.68 / $702.81 / $1,447.15	Professional		$341.68	$702.81	$1,447.15