Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $35.67 / $312.42 / $1,894.00	Facility		$35.67	$312.42	$1,894.00
Aetna Facility/Professional Professional Modifier Low / Median / High Price $32.54 / $83.15 / $376.47	Professional		$32.54	$83.15	$376.47
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 $55.69 / $129.87 / $323.70	Professional		$55.69	$129.87	$323.70
Anthem BCBS Facility/Professional Professional Modifier 50 Low / Median / High Price $92.43 / $194.80 / $487.92	Professional	50	$92.43	$194.80	$487.92
CareSource Facility/Professional Facility Modifier Low / Median / High Price $33.97 / $34.26 / $47.26	Facility		$33.97	$34.26	$47.26
CareSource Facility/Professional Professional Modifier Low / Median / High Price $77.91 / $85.70 / $103.36	Professional		$77.91	$85.70	$103.36
Cigna Facility/Professional Facility Modifier Low / Median / High Price $235.19 / $274.83 / $421.61	Facility		$235.19	$274.83	$421.61
Cigna Facility/Professional Professional Modifier Low / Median / High Price $37.88 / $95.95 / $225.89	Professional		$37.88	$95.95	$225.89
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $36.54 / $93.49 / $228.06	Facility		$36.54	$93.49	$228.06
Medica Facility/Professional Facility Modifier Low / Median / High Price $37.71 / $105.03 / $1,513.00	Facility		$37.71	$105.03	$1,513.00
Medica Facility/Professional Professional Modifier Low / Median / High Price $72.34 / $152.78 / $358.36	Professional		$72.34	$152.78	$358.36
Molina Facility/Professional Professional Modifier Low / Median / High Price $58.91 / $95.42 / $218.92	Professional		$58.91	$95.42	$218.92
Prevea360 Facility/Professional Facility Modifier Low / Median / High Price $36.54 / $93.49 / $228.06	Facility		$36.54	$93.49	$228.06
Quartz Facility/Professional Professional Modifier Low / Median / High Price $84.39 / $147.62 / $274.77	Professional		$84.39	$147.62	$274.77
Quartz Facility/Professional Facility Modifier Low / Median / High Price $72.29 / $96.61 / $176.16	Facility		$72.29	$96.61	$176.16
Quartz Facility/Professional Professional Modifier Low / Median / High Price $47.80 / $177.65 / $644.40	Professional		$47.80	$177.65	$644.40
Security Health Facility/Professional Professional Modifier Low / Median / High Price $80.09 / $159.53 / $375.65	Professional		$80.09	$159.53	$375.65
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 $72.67 / $131.80 / $310.18	Professional		$72.67	$131.80	$310.18