Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $57.00 / $549.37 / $1,894.00	Facility		$57.00	$549.37	$1,894.00
Aetna Facility/Professional Facility Modifier 50 Low / Median / High Price $2,841.00 / $2,841.00 / $2,841.00	Facility	50	$2,841.00	$2,841.00	$2,841.00
Aetna Facility/Professional Professional Modifier Low / Median / High Price $38.04 / $100.27 / $410.67	Professional		$38.04	$100.27	$410.67
Aetna Facility/Professional Professional Modifier 50 Low / Median / High Price $74.91 / $285.00 / $573.75	Professional	50	$74.91	$285.00	$573.75
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 $47.83 / $88.72 / $232.01	Professional		$47.83	$88.72	$232.01
Anthem BCBS Facility/Professional Professional Modifier 50 Low / Median / High Price $73.29 / $137.29 / $348.01	Professional	50	$73.29	$137.29	$348.01
CareSource Facility/Professional Facility Modifier Low / Median / High Price $37.03 / $45.88 / $66.50	Facility		$37.03	$45.88	$66.50
CareSource Facility/Professional Professional Modifier Low / Median / High Price $52.67 / $55.30 / $73.84	Professional		$52.67	$55.30	$73.84
Cigna Facility/Professional Facility Modifier Low / Median / High Price $152.29 / $177.96 / $273.00	Facility		$152.29	$177.96	$273.00
Cigna Facility/Professional Professional Modifier Low / Median / High Price $62.67 / $147.99 / $259.75	Professional		$62.67	$147.99	$259.75
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $37.92 / $58.61 / $119.68	Facility		$37.92	$58.61	$119.68
Medica Facility/Professional Facility Modifier Low / Median / High Price $38.40 / $75.91 / $1,449.00	Facility		$38.40	$75.91	$1,449.00
Medica Facility/Professional Facility Modifier 50 Low / Median / High Price $869.95 / $869.95 / $869.95	Facility	50	$869.95	$869.95	$869.95
Medica Facility/Professional Professional Modifier Low / Median / High Price $63.32 / $144.94 / $613.73	Professional		$63.32	$144.94	$613.73
Medica Facility/Professional Professional Modifier 50 Low / Median / High Price $135.51 / $188.20 / $494.10	Professional	50	$135.51	$188.20	$494.10
Molina Facility/Professional Professional Modifier Low / Median / High Price $41.03 / $75.84 / $156.20	Professional		$41.03	$75.84	$156.20
Prevea360 Facility/Professional Facility Modifier Low / Median / High Price $37.92 / $58.36 / $119.68	Facility		$37.92	$58.36	$119.68
Quartz Facility/Professional Professional Modifier Low / Median / High Price $89.22 / $132.87 / $196.74	Professional		$89.22	$132.87	$196.74
Quartz Facility/Professional Facility Modifier Low / Median / High Price $59.81 / $59.81 / $177.14	Facility		$59.81	$59.81	$177.14
Quartz Facility/Professional Professional Modifier Low / Median / High Price $83.67 / $244.89 / $613.73	Professional		$83.67	$244.89	$613.73
Security Health Facility/Professional Professional Modifier Low / Median / High Price $118.16 / $244.55 / $370.21	Professional		$118.16	$244.55	$370.21
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 $58.05 / $106.55 / $240.90	Professional		$58.05	$106.55	$240.90