Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $69.73 / $276.39 / $3,519.18	Facility		$69.73	$276.39	$3,519.18
Aetna Facility/Professional Professional Modifier Low / Median / High Price $73.54 / $136.50 / $546.00	Professional		$73.54	$136.50	$546.00
Aetna Facility/Professional Professional Modifier 52 Low / Median / High Price $34.86 / $56.79 / $147.52	Professional	52	$34.86	$56.79	$147.52
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 $97.17 / $188.87 / $442.41	Professional		$97.17	$188.87	$442.41
CareSource Facility/Professional Facility Modifier Low / Median / High Price $77.08 / $78.26 / $105.75	Facility		$77.08	$78.26	$105.75
CareSource Facility/Professional Professional Modifier Low / Median / High Price $122.84 / $135.12 / $163.03	Professional		$122.84	$135.12	$163.03
Cigna Facility/Professional Facility Modifier Low / Median / High Price $361.35 / $422.27 / $647.77	Facility		$361.35	$422.27	$647.77
Cigna Facility/Professional Professional Modifier Low / Median / High Price $85.45 / $181.91 / $368.06	Professional		$85.45	$181.91	$368.06
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $82.32 / $156.52 / $360.09	Facility		$82.32	$156.52	$360.09
Medica Facility/Professional Facility Modifier Low / Median / High Price $83.63 / $231.24 / $1,642.00	Facility		$83.63	$231.24	$1,642.00
Medica Facility/Professional Professional Modifier Low / Median / High Price $122.09 / $254.32 / $624.79	Professional		$122.09	$254.32	$624.79
Molina Facility/Professional Professional Modifier Low / Median / High Price $70.00 / $123.56 / $276.87	Professional		$70.00	$123.56	$276.87
Prevea360 Facility/Professional Facility Modifier Low / Median / High Price $82.32 / $156.52 / $360.09	Facility		$82.32	$156.52	$360.09
Quartz Facility/Professional Professional Modifier Low / Median / High Price $179.52 / $286.67 / $431.64	Professional		$179.52	$286.67	$431.64
Quartz Facility/Professional Facility Modifier Low / Median / High Price $165.13 / $220.69 / $393.76	Facility		$165.13	$220.69	$393.76
Quartz Facility/Professional Professional Modifier Low / Median / High Price $108.12 / $399.45 / $993.12	Professional		$108.12	$399.45	$993.12
Security Health Facility/Professional Professional Modifier Low / Median / High Price $174.48 / $360.85 / $578.36	Professional		$174.48	$360.85	$578.36
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 $122.19 / $200.22 / $508.87	Professional		$122.19	$200.22	$508.87