Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $110.37 / $466.90 / $4,497.97	Facility		$110.37	$466.90	$4,497.97
Aetna Facility/Professional Facility Modifier 52 Low / Median / High Price $40.57 / $100.35 / $239.68	Facility	52	$40.57	$100.35	$239.68
Aetna Facility/Professional Professional Modifier Low / Median / High Price $84.44 / $148.75 / $538.00	Professional		$84.44	$148.75	$538.00
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 $122.84 / $252.96 / $531.35	Professional		$122.84	$252.96	$531.35
CareSource Facility/Professional Facility Modifier Low / Median / High Price $88.27 / $89.20 / $122.27	Facility		$88.27	$89.20	$122.27
CareSource Facility/Professional Professional Modifier Low / Median / High Price $119.54 / $131.49 / $161.26	Professional		$119.54	$131.49	$161.26
Cigna Facility/Professional Facility Modifier Low / Median / High Price $347.83 / $406.47 / $623.53	Facility		$347.83	$406.47	$623.53
Cigna Facility/Professional Professional Modifier Low / Median / High Price $102.49 / $209.19 / $357.65	Professional		$102.49	$209.19	$357.65
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $94.74 / $155.40 / $352.98	Facility		$94.74	$155.40	$352.98
Medica Facility/Professional Facility Modifier Low / Median / High Price $96.03 / $251.18 / $1,513.00	Facility		$96.03	$251.18	$1,513.00
Medica Facility/Professional Facility Modifier 52 Low / Median / High Price $354.86 / $354.86 / $354.86	Facility	52	$354.86	$354.86	$354.86
Medica Facility/Professional Professional Modifier Low / Median / High Price $119.54 / $250.48 / $721.84	Professional		$119.54	$250.48	$721.84
Molina Facility/Professional Professional Modifier Low / Median / High Price $70.00 / $123.56 / $276.87	Professional		$70.00	$123.56	$276.87
Prevea360 Facility/Professional Facility Modifier Low / Median / High Price $94.74 / $155.40 / $352.98	Facility		$94.74	$155.40	$352.98
Quartz Facility/Professional Professional Modifier Low / Median / High Price $210.45 / $301.58 / $422.98	Professional		$210.45	$301.58	$422.98
Quartz Facility/Professional Facility Modifier Low / Median / High Price $188.21 / $251.54 / $443.57	Facility		$188.21	$251.54	$443.57
Quartz Facility/Professional Facility Modifier 52 Low / Median / High Price $150.57 / $201.23 / $354.86	Facility	52	$150.57	$201.23	$354.86
Quartz Facility/Professional Professional Modifier Low / Median / High Price $153.01 / $458.60 / $967.36	Professional		$153.01	$458.60	$967.36
Security Health Facility/Professional Professional Modifier Low / Median / High Price $174.75 / $414.99 / $559.99	Professional		$174.75	$414.99	$559.99
United Facility/Professional Facility Modifier Low / Median / High Price $1,008.00 / $1,423.00 / $2,202.90	Facility		$1,008.00	$1,423.00	$2,202.90
United Facility/Professional Professional Modifier Low / Median / High Price $119.11 / $203.04 / $522.78	Professional		$119.11	$203.04	$522.78