Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $65.56 / $236.27 / $552.64	Facility		$65.56	$236.27	$552.64
Aetna Facility/Professional Professional Modifier Low / Median / High Price $63.31 / $168.27 / $476.43	Professional		$63.31	$168.27	$476.43
Aetna Facility/Professional Professional Modifier 52 Low / Median / High Price $28.51 / $48.71 / $120.76	Professional	52	$28.51	$48.71	$120.76
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 $79.44 / $158.44 / $378.26	Professional		$79.44	$158.44	$378.26
Anthem BCBS Facility/Professional Professional Modifier 50 Low / Median / High Price $120.88 / $242.98 / $567.39	Professional	50	$120.88	$242.98	$567.39
CareSource Facility/Professional Facility Modifier Low / Median / High Price $63.25 / $64.45 / $86.18	Facility		$63.25	$64.45	$86.18
CareSource Facility/Professional Professional Modifier Low / Median / High Price $105.01 / $115.51 / $138.29	Professional		$105.01	$115.51	$138.29
Cigna Facility/Professional Facility Modifier Low / Median / High Price $310.89 / $363.30 / $557.29	Facility		$310.89	$363.30	$557.29
Cigna Facility/Professional Professional Modifier Low / Median / High Price $69.31 / $154.00 / $322.64	Professional		$69.31	$154.00	$322.64
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $66.70 / $128.91 / $306.95	Facility		$66.70	$128.91	$306.95
Medica Facility/Professional Facility Modifier Low / Median / High Price $68.48 / $189.75 / $1,642.00	Facility		$68.48	$189.75	$1,642.00
Medica Facility/Professional Professional Modifier Low / Median / High Price $105.46 / $236.63 / $524.63	Professional		$105.46	$236.63	$524.63
Molina Facility/Professional Professional Modifier Low / Median / High Price $70.00 / $123.56 / $274.18	Professional		$70.00	$123.56	$274.18
Prevea360 Facility/Professional Facility Modifier Low / Median / High Price $66.70 / $128.91 / $306.95	Facility		$66.70	$128.91	$306.95
Quartz Facility/Professional Professional Modifier Low / Median / High Price $147.09 / $234.96 / $367.81	Professional		$147.09	$234.96	$367.81
Quartz Facility/Professional Facility Modifier Low / Median / High Price $136.01 / $181.78 / $324.92	Facility		$136.01	$181.78	$324.92
Quartz Facility/Professional Professional Modifier Low / Median / High Price $108.84 / $324.45 / $848.56	Professional		$108.84	$324.45	$848.56
Security Health Facility/Professional Professional Modifier Low / Median / High Price $127.83 / $298.14 / $495.33	Professional		$127.83	$298.14	$495.33
United Facility/Professional Facility Modifier Low / Median / High Price $785.00 / $1,370.00 / $2,202.90	Facility		$785.00	$1,370.00	$2,202.90
United Facility/Professional Professional Modifier Low / Median / High Price $97.24 / $152.47 / $405.19	Professional		$97.24	$152.47	$405.19