Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $44.86 / $167.78 / $1,894.00	Facility		$44.86	$167.78	$1,894.00
Aetna Facility/Professional Facility Modifier 50 Low / Median / High Price $2,793.99 / $2,793.99 / $2,793.99	Facility	50	$2,793.99	$2,793.99	$2,793.99
Aetna Facility/Professional Professional Modifier Low / Median / High Price $44.86 / $81.48 / $405.17	Professional		$44.86	$81.48	$405.17
Aetna Facility/Professional Professional Modifier 50 Low / Median / High Price $99.29 / $259.49 / $948.32	Professional	50	$99.29	$259.49	$948.32
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 $67.29 / $157.09 / $361.32	Professional		$67.29	$157.09	$361.32
Anthem BCBS Facility/Professional Professional Modifier 50 Low / Median / High Price $107.41 / $235.63 / $541.98	Professional	50	$107.41	$235.63	$541.98
CareSource Facility/Professional Facility Modifier Low / Median / High Price $44.00 / $54.50 / $110.20	Facility		$44.00	$54.50	$110.20
CareSource Facility/Professional Professional Modifier Low / Median / High Price $75.11 / $78.87 / $104.44	Professional		$75.11	$78.87	$104.44
Cigna Facility/Professional Facility Modifier Low / Median / High Price $221.68 / $259.05 / $397.38	Facility		$221.68	$259.05	$397.38
Cigna Facility/Professional Professional Modifier Low / Median / High Price $77.79 / $181.72 / $367.87	Professional		$77.79	$181.72	$367.87
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $45.36 / $84.49 / $170.60	Facility		$45.36	$84.49	$170.60
Medica Facility/Professional Facility Modifier Low / Median / High Price $45.62 / $95.58 / $1,449.00	Facility		$45.62	$95.58	$1,449.00
Medica Facility/Professional Professional Modifier Low / Median / High Price $82.23 / $166.32 / $618.24	Professional		$82.23	$166.32	$618.24
Medica Facility/Professional Professional Modifier 50 Low / Median / High Price $510.12 / $510.12 / $510.12	Professional	50	$510.12	$510.12	$510.12
Molina Facility/Professional Professional Modifier Low / Median / High Price $40.93 / $85.00 / $161.50	Professional		$40.93	$85.00	$161.50
Prevea360 Facility/Professional Facility Modifier Low / Median / High Price $45.36 / $84.49 / $170.60	Facility		$45.36	$84.49	$170.60
Quartz Facility/Professional Professional Modifier Low / Median / High Price $106.02 / $180.00 / $281.05	Professional		$106.02	$180.00	$281.05
Quartz Facility/Professional Facility Modifier Low / Median / High Price $99.04 / $99.04 / $210.41	Facility		$99.04	$99.04	$210.41
Quartz Facility/Professional Professional Modifier Low / Median / High Price $95.84 / $340.80 / $618.24	Professional		$95.84	$340.80	$618.24
Security Health Facility/Professional Professional Modifier Low / Median / High Price $171.43 / $289.23 / $534.12	Professional		$171.43	$289.23	$534.12
United Facility/Professional Facility Modifier Low / Median / High Price $1,008.00 / $1,370.00 / $2,202.90	Facility		$1,008.00	$1,370.00	$2,202.90
United Facility/Professional Professional Modifier Low / Median / High Price $80.11 / $162.28 / $330.52	Professional		$80.11	$162.28	$330.52