Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $77.91 / $343.18 / $3,119.00	Facility		$77.91	$343.18	$3,119.00
Aetna Facility/Professional Professional Modifier Low / Median / High Price $77.91 / $139.37 / $518.03	Professional		$77.91	$139.37	$518.03
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $1,183.00 / $3,483.00 / $5,962.00	Facility		$1,183.00	$3,483.00	$5,962.00
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $134.63 / $282.05 / $606.66	Professional		$134.63	$282.05	$606.66
Anthem BCBS Facility/Professional Professional Modifier 50 Low / Median / High Price $221.91 / $448.30 / $919.29	Professional	50	$221.91	$448.30	$919.29
CareSource Facility/Professional Facility Modifier Low / Median / High Price $85.58 / $85.58 / $119.46	Facility		$85.58	$85.58	$119.46
CareSource Facility/Professional Professional Modifier Low / Median / High Price $146.25 / $160.88 / $197.42	Professional		$146.25	$160.88	$197.42
Cigna Facility/Professional Facility Modifier Low / Median / High Price $424.43 / $495.98 / $760.84	Facility		$424.43	$495.98	$760.84
Cigna Facility/Professional Professional Modifier Low / Median / High Price $103.18 / $219.18 / $412.32	Professional		$103.18	$219.18	$412.32
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $93.23 / $187.20 / $438.72	Facility		$93.23	$187.20	$438.72
Medica Facility/Professional Facility Modifier Low / Median / High Price $93.79 / $256.74 / $5,169.00	Facility		$93.79	$256.74	$5,169.00
Medica Facility/Professional Professional Modifier Low / Median / High Price $151.63 / $289.60 / $3,179.06	Professional		$151.63	$289.60	$3,179.06
Molina Facility/Professional Professional Modifier Low / Median / High Price $97.44 / $159.30 / $366.38	Professional		$97.44	$159.30	$366.38
Prevea360 Facility/Professional Facility Modifier Low / Median / High Price $93.23 / $187.20 / $438.72	Facility		$93.23	$187.20	$438.72
Quartz Facility/Professional Professional Modifier Low / Median / High Price $206.68 / $314.77 / $514.94	Professional		$206.68	$314.77	$514.94
Quartz Facility/Professional Facility Modifier Low / Median / High Price $180.57 / $241.34 / $650.76	Facility		$180.57	$241.34	$650.76
Quartz Facility/Professional Professional Modifier Low / Median / High Price $118.53 / $391.05 / $3,593.56	Professional		$118.53	$391.05	$3,593.56
Security Health Facility/Professional Professional Modifier Low / Median / High Price $210.49 / $395.60 / $685.68	Professional		$210.49	$395.60	$685.68
United Facility/Professional Facility Modifier Low / Median / High Price $2,960.00 / $4,155.00 / $5,865.00	Facility		$2,960.00	$4,155.00	$5,865.00
United Facility/Professional Professional Modifier Low / Median / High Price $144.38 / $260.64 / $632.88	Professional		$144.38	$260.64	$632.88