Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $37.92 / $119.21 / $1,894.00	Facility		$37.92	$119.21	$1,894.00
Aetna Facility/Professional Professional Modifier Low / Median / High Price $38.34 / $74.73 / $403.75	Professional		$38.34	$74.73	$403.75
Aetna Facility/Professional Professional Modifier 50 Low / Median / High Price $73.20 / $80.09 / $168.03	Professional	50	$73.20	$80.09	$168.03
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 $48.86 / $91.53 / $247.91	Professional		$48.86	$91.53	$247.91
Anthem BCBS Facility/Professional Professional Modifier 50 Low / Median / High Price $73.29 / $137.29 / $373.98	Professional	50	$73.29	$137.29	$373.98
CareSource Facility/Professional Facility Modifier Low / Median / High Price $36.36 / $45.00 / $69.50	Facility		$36.36	$45.00	$69.50
CareSource Facility/Professional Professional Modifier Low / Median / High Price $52.36 / $54.98 / $73.01	Professional		$52.36	$54.98	$73.01
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 $61.66 / $147.09 / $257.41	Professional		$61.66	$147.09	$257.41
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $37.92 / $58.61 / $119.21	Facility		$37.92	$58.61	$119.21
Medica Facility/Professional Facility Modifier Low / Median / High Price $38.71 / $72.23 / $1,449.00	Facility		$38.71	$72.23	$1,449.00
Medica Facility/Professional Professional Modifier Low / Median / High Price $63.98 / $129.38 / $429.84	Professional		$63.98	$129.38	$429.84
Molina Facility/Professional Professional Modifier Low / Median / High Price $41.03 / $77.65 / $156.20	Professional		$41.03	$77.65	$156.20
Prevea360 Facility/Professional Facility Modifier Low / Median / High Price $37.92 / $58.61 / $119.21	Facility		$37.92	$58.61	$119.21
Quartz Facility/Professional Professional Modifier Low / Median / High Price $87.70 / $130.59 / $194.49	Professional		$87.70	$130.59	$194.49
Quartz Facility/Professional Facility Modifier Low / Median / High Price $59.81 / $59.81 / $174.10	Facility		$59.81	$59.81	$174.10
Quartz Facility/Professional Professional Modifier Low / Median / High Price $81.37 / $244.40 / $429.84	Professional		$81.37	$244.40	$429.84
Security Health Facility/Professional Professional Modifier Low / Median / High Price $117.42 / $243.79 / $369.45	Professional		$117.42	$243.79	$369.45
United Facility/Professional Facility Modifier Low / Median / High Price $953.00 / $1,370.00 / $2,202.90	Facility		$953.00	$1,370.00	$2,202.90
United Facility/Professional Professional Modifier Low / Median / High Price $60.63 / $116.78 / $241.75	Professional		$60.63	$116.78	$241.75