Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $564.90 / $1,784.94 / $3,199.44	Facility		$564.90	$1,784.94	$3,199.44
Aetna Facility/Professional Facility Modifier 52 Low / Median / High Price $30.70 / $30.70 / $57.78	Facility	52	$30.70	$30.70	$57.78
Aetna Facility/Professional Professional Modifier Low / Median / High Price $61.40 / $125.78 / $607.75	Professional		$61.40	$125.78	$607.75
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $1,139.00 / $2,479.00 / $4,441.52	Facility		$1,139.00	$2,479.00	$4,441.52
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $118.17 / $259.67 / $597.24	Professional		$118.17	$259.67	$597.24
CareSource Facility/Professional Facility Modifier Low / Median / High Price $68.78 / $104.19 / $104.19	Facility		$68.78	$104.19	$104.19
CareSource Facility/Professional Professional Modifier Low / Median / High Price $126.44 / $180.32 / $278.70	Professional		$126.44	$180.32	$278.70
Cigna Facility/Professional Facility Modifier Low / Median / High Price $358.65 / $419.11 / $676.00	Facility		$358.65	$419.11	$676.00
Cigna Facility/Professional Professional Modifier Low / Median / High Price $135.88 / $251.95 / $441.90	Professional		$135.88	$251.95	$441.90
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $65.95 / $115.55 / $206.16	Facility		$65.95	$115.55	$206.16
Medica Facility/Professional Facility Modifier Low / Median / High Price $79.15 / $682.69 / $4,195.00	Facility		$79.15	$682.69	$4,195.00
Medica Facility/Professional Professional Modifier Low / Median / High Price $145.88 / $388.92 / $549.74	Professional		$145.88	$388.92	$549.74
Molina Facility/Professional Professional Modifier Low / Median / High Price $58.91 / $122.30 / $245.79	Professional		$58.91	$122.30	$245.79
Prevea360 Facility/Professional Facility Modifier Low / Median / High Price $65.95 / $115.55 / $206.16	Facility		$65.95	$115.55	$206.16
Quartz Facility/Professional Professional Modifier Low / Median / High Price $158.26 / $246.43 / $453.10	Professional		$158.26	$246.43	$453.10
Quartz Facility/Professional Facility Modifier Low / Median / High Price $328.49 / $328.49 / $328.49	Facility		$328.49	$328.49	$328.49
Quartz Facility/Professional Facility Modifier 52 Low / Median / High Price $262.79 / $262.79 / $262.79	Facility	52	$262.79	$262.79	$262.79
Quartz Facility/Professional Professional Modifier Low / Median / High Price $139.18 / $353.20 / $1,001.20	Professional		$139.18	$353.20	$1,001.20
Security Health Facility/Professional Professional Modifier Low / Median / High Price $123.86 / $268.18 / $504.64	Professional		$123.86	$268.18	$504.64
United Facility/Professional Facility Modifier Low / Median / High Price $2,367.00 / $3,088.30 / $4,295.00	Facility		$2,367.00	$3,088.30	$4,295.00
United Facility/Professional Professional Modifier Low / Median / High Price $140.57 / $389.29 / $520.58	Professional		$140.57	$389.29	$520.58