Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $41.15 / $425.75 / $1,894.00	Facility		$41.15	$425.75	$1,894.00
Aetna Facility/Professional Professional Modifier Low / Median / High Price $36.25 / $83.35 / $320.83	Professional		$36.25	$83.35	$320.83
Aetna Facility/Professional Professional Modifier 50 Low / Median / High Price $96.88 / $312.66 / $643.88	Professional	50	$96.88	$312.66	$643.88
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 $48.96 / $105.53 / $267.30	Professional		$48.96	$105.53	$267.30
Anthem BCBS Facility/Professional Professional Modifier 50 Low / Median / High Price $73.44 / $159.47 / $405.73	Professional	50	$73.44	$159.47	$405.73
CareSource Facility/Professional Facility Modifier Low / Median / High Price $34.69 / $43.06 / $67.48	Facility		$34.69	$43.06	$67.48
CareSource Facility/Professional Professional Modifier Low / Median / High Price $49.79 / $52.28 / $69.45	Professional		$49.79	$52.28	$69.45
Cigna Facility/Professional Facility Modifier Low / Median / High Price $145.97 / $170.59 / $261.69	Facility		$145.97	$170.59	$261.69
Cigna Facility/Professional Professional Modifier Low / Median / High Price $59.28 / $140.18 / $252.50	Professional		$59.28	$140.18	$252.50
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $35.95 / $55.82 / $113.40	Facility		$35.95	$55.82	$113.40
Medica Facility/Professional Facility Modifier Low / Median / High Price $37.35 / $73.19 / $1,449.00	Facility		$37.35	$73.19	$1,449.00
Medica Facility/Professional Professional Modifier Low / Median / High Price $59.39 / $130.65 / $411.20	Professional		$59.39	$130.65	$411.20
Medica Facility/Professional Professional Modifier 50 Low / Median / High Price $142.37 / $142.37 / $143.63	Professional	50	$142.37	$142.37	$143.63
Molina Facility/Professional Professional Modifier Low / Median / High Price $41.03 / $75.71 / $156.20	Professional		$41.03	$75.71	$156.20
Prevea360 Facility/Professional Facility Modifier Low / Median / High Price $35.95 / $55.82 / $113.40	Facility		$35.95	$55.82	$113.40
Quartz Facility/Professional Professional Modifier Low / Median / High Price $83.89 / $124.92 / $185.49	Professional		$83.89	$124.92	$185.49
Quartz Facility/Professional Facility Modifier Low / Median / High Price $59.16 / $59.16 / $166.51	Facility		$59.16	$59.16	$166.51
Quartz Facility/Professional Professional Modifier Low / Median / High Price $79.48 / $233.91 / $411.20	Professional		$79.48	$233.91	$411.20
Security Health Facility/Professional Professional Modifier Low / Median / High Price $119.69 / $232.24 / $353.62	Professional		$119.69	$232.24	$353.62
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 $56.46 / $98.30 / $228.64	Professional		$56.46	$98.30	$228.64