Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $12.85 / $52.73 / $1,894.00	Facility		$12.85	$52.73	$1,894.00
Aetna Facility/Professional Professional Modifier Low / Median / High Price $12.85 / $29.67 / $137.00	Professional		$12.85	$29.67	$137.00
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 $22.73 / $48.41 / $122.69	Professional		$22.73	$48.41	$122.69
Anthem BCBS Facility/Professional Professional Modifier 50 Low / Median / High Price $35.19 / $74.95 / $189.51	Professional	50	$35.19	$74.95	$189.51
CareSource Facility/Professional Facility Modifier Low / Median / High Price $13.15 / $13.21 / $18.51	Facility		$13.15	$13.21	$18.51
CareSource Facility/Professional Professional Modifier Low / Median / High Price $30.48 / $33.53 / $40.78	Professional		$30.48	$33.53	$40.78
Cigna Facility/Professional Facility Modifier Low / Median / High Price $89.21 / $104.25 / $159.91	Facility		$89.21	$104.25	$159.91
Cigna Facility/Professional Professional Modifier Low / Median / High Price $16.30 / $36.17 / $95.94	Professional		$16.30	$36.17	$95.94
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $14.74 / $36.58 / $90.63	Facility		$14.74	$36.58	$90.63
Medica Facility/Professional Facility Modifier Low / Median / High Price $15.78 / $41.30 / $1,513.00	Facility		$15.78	$41.30	$1,513.00
Medica Facility/Professional Professional Modifier Low / Median / High Price $30.16 / $62.74 / $139.19	Professional		$30.16	$62.74	$139.19
Molina Facility/Professional Professional Modifier Low / Median / High Price $19.34 / $33.89 / $72.74	Professional		$19.34	$33.89	$72.74
Prevea360 Facility/Professional Facility Modifier Low / Median / High Price $14.74 / $36.58 / $90.63	Facility		$14.74	$36.58	$90.63
Quartz Facility/Professional Professional Modifier Low / Median / High Price $32.43 / $57.54 / $107.10	Professional		$32.43	$57.54	$107.10
Quartz Facility/Professional Facility Modifier Low / Median / High Price $27.75 / $37.08 / $65.09	Facility		$27.75	$37.08	$65.09
Quartz Facility/Professional Professional Modifier Low / Median / High Price $18.02 / $71.45 / $246.24	Professional		$18.02	$71.45	$246.24
Security Health Facility/Professional Professional Modifier Low / Median / High Price $32.47 / $60.16 / $142.82	Professional		$32.47	$60.16	$142.82
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 $29.36 / $51.73 / $131.80	Professional		$29.36	$51.73	$131.80