Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $18.61 / $111.05 / $1,894.00	Facility		$18.61	$111.05	$1,894.00
Aetna Facility/Professional Professional Modifier Low / Median / High Price $19.17 / $70.25 / $271.00	Professional		$19.17	$70.25	$271.00
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 $35.54 / $94.06 / $285.27	Professional		$35.54	$94.06	$285.27
Anthem BCBS Facility/Professional Professional Modifier 50 Low / Median / High Price $60.39 / $145.74 / $427.92	Professional	50	$60.39	$145.74	$427.92
CareSource Facility/Professional Facility Modifier Low / Median / High Price $20.32 / $20.38 / $28.42	Facility		$20.32	$20.38	$28.42
CareSource Facility/Professional Professional Modifier Low / Median / High Price $75.42 / $82.96 / $99.23	Professional		$75.42	$82.96	$99.23
Cigna Facility/Professional Facility Modifier Low / Median / High Price $225.28 / $263.26 / $403.84	Facility		$225.28	$263.26	$403.84
Cigna Facility/Professional Professional Modifier Low / Median / High Price $25.19 / $64.05 / $229.28	Professional		$25.19	$64.05	$229.28
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $22.40 / $63.96 / $220.41	Facility		$22.40	$63.96	$220.41
Medica Facility/Professional Facility Modifier Low / Median / High Price $24.38 / $90.50 / $1,513.00	Facility		$24.38	$90.50	$1,513.00
Medica Facility/Professional Professional Modifier Low / Median / High Price $55.69 / $113.72 / $314.27	Professional		$55.69	$113.72	$314.27
Molina Facility/Professional Professional Modifier Low / Median / High Price $58.42 / $93.15 / $218.92	Professional		$58.42	$93.15	$218.92
Prevea360 Facility/Professional Facility Modifier Low / Median / High Price $22.40 / $63.96 / $220.41	Facility		$22.40	$63.96	$220.41
Quartz Facility/Professional Professional Modifier Low / Median / High Price $49.29 / $91.63 / $263.95	Professional		$49.29	$91.63	$263.95
Quartz Facility/Professional Facility Modifier Low / Median / High Price $42.88 / $57.30 / $99.92	Facility		$42.88	$57.30	$99.92
Quartz Facility/Professional Professional Modifier Low / Median / High Price $28.08 / $130.40 / $614.64	Professional		$28.08	$130.40	$614.64
Security Health Facility/Professional Professional Modifier Low / Median / High Price $50.31 / $93.95 / $359.13	Professional		$50.31	$93.95	$359.13
United Facility/Professional Facility Modifier Low / Median / High Price $1,034.00 / $1,423.00 / $2,202.90	Facility		$1,034.00	$1,423.00	$2,202.90
United Facility/Professional Professional Modifier Low / Median / High Price $59.36 / $104.84 / $267.13	Professional		$59.36	$104.84	$267.13