Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $25.20 / $87.90 / $283.60	Facility		$25.20	$87.90	$283.60
Aetna Facility/Professional Professional Modifier Low / Median / High Price $21.46 / $41.73 / $180.00	Professional		$21.46	$41.73	$180.00
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 $35.01 / $75.09 / $173.59	Professional		$35.01	$75.09	$173.59
Anthem BCBS Facility/Professional Professional Modifier 50 Low / Median / High Price $57.60 / $117.50 / $262.80	Professional	50	$57.60	$117.50	$262.80
CareSource Facility/Professional Facility Modifier Low / Median / High Price $21.92 / $21.97 / $30.55	Facility		$21.92	$21.97	$30.55
CareSource Facility/Professional Professional Modifier Low / Median / High Price $41.73 / $45.90 / $56.01	Professional		$41.73	$45.90	$56.01
Cigna Facility/Professional Facility Modifier Low / Median / High Price $119.85 / $140.05 / $214.84	Facility		$119.85	$140.05	$214.84
Cigna Facility/Professional Professional Modifier Low / Median / High Price $27.18 / $56.10 / $122.71	Professional		$27.18	$56.10	$122.71
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $24.13 / $50.14 / $124.47	Facility		$24.13	$50.14	$124.47
Medica Facility/Professional Facility Modifier Low / Median / High Price $26.30 / $65.91 / $1,513.00	Facility		$26.30	$65.91	$1,513.00
Medica Facility/Professional Professional Modifier Low / Median / High Price $43.41 / $87.42 / $193.01	Professional		$43.41	$87.42	$193.01
Molina Facility/Professional Professional Modifier Low / Median / High Price $39.56 / $65.66 / $147.46	Professional		$39.56	$65.66	$147.46
Prevea360 Facility/Professional Facility Modifier Low / Median / High Price $24.13 / $50.14 / $124.47	Facility		$24.13	$50.14	$124.47
Quartz Facility/Professional Professional Modifier Low / Median / High Price $52.80 / $81.00 / $146.04	Professional		$52.80	$81.00	$146.04
Quartz Facility/Professional Facility Modifier Low / Median / High Price $46.25 / $61.81 / $107.50	Facility		$46.25	$61.81	$107.50
Quartz Facility/Professional Professional Modifier Low / Median / High Price $30.33 / $122.60 / $335.60	Professional		$30.33	$122.60	$335.60
Security Health Facility/Professional Professional Modifier Low / Median / High Price $54.64 / $101.26 / $194.05	Professional		$54.64	$101.26	$194.05
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 $41.73 / $70.04 / $182.77	Professional		$41.73	$70.04	$182.77