Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $50.63 / $330.18 / $2,269.83	Facility		$50.63	$330.18	$2,269.83
Aetna Facility/Professional Professional Modifier Low / Median / High Price $50.63 / $88.47 / $477.40	Professional		$50.63	$88.47	$477.40
Aetna Facility/Professional Professional Modifier 50 Low / Median / High Price $109.71 / $127.59 / $1,890.50	Professional	50	$109.71	$127.59	$1,890.50
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 $76.19 / $170.13 / $404.57	Professional		$76.19	$170.13	$404.57
Anthem BCBS Facility/Professional Professional Modifier 50 Low / Median / High Price $118.39 / $255.19 / $606.85	Professional	50	$118.39	$255.19	$606.85
CareSource Facility/Professional Facility Modifier Low / Median / High Price $49.36 / $61.15 / $119.13	Facility		$49.36	$61.15	$119.13
CareSource Facility/Professional Professional Modifier Low / Median / High Price $81.20 / $85.27 / $113.01	Professional		$81.20	$85.27	$113.01
Cigna Facility/Professional Facility Modifier Low / Median / High Price $239.70 / $280.11 / $429.69	Facility		$239.70	$280.11	$429.69
Cigna Facility/Professional Professional Modifier Low / Median / High Price $84.78 / $205.62 / $413.15	Professional		$84.78	$205.62	$413.15
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $51.21 / $91.40 / $184.17	Facility		$51.21	$91.40	$184.17
Medica Facility/Professional Facility Modifier Low / Median / High Price $51.69 / $107.34 / $3,034.00	Facility		$51.69	$107.34	$3,034.00
Medica Facility/Professional Facility Modifier 50 Low / Median / High Price $765.57 / $765.57 / $765.57	Facility	50	$765.57	$765.57	$765.57
Medica Facility/Professional Professional Modifier Low / Median / High Price $91.22 / $180.65 / $671.04	Professional		$91.22	$180.65	$671.04
Molina Facility/Professional Professional Modifier Low / Median / High Price $58.91 / $100.37 / $235.85	Professional		$58.91	$100.37	$235.85
Prevea360 Facility/Professional Facility Modifier Low / Median / High Price $51.21 / $91.40 / $184.17	Facility		$51.21	$91.40	$184.17
Quartz Facility/Professional Professional Modifier Low / Median / High Price $118.98 / $194.40 / $303.52	Professional		$118.98	$194.40	$303.52
Quartz Facility/Professional Facility Modifier Low / Median / High Price $104.34 / $104.34 / $236.15	Facility		$104.34	$104.34	$236.15
Quartz Facility/Professional Professional Modifier Low / Median / High Price $109.20 / $382.73 / $671.04	Professional		$109.20	$382.73	$671.04
Security Health Facility/Professional Professional Modifier Low / Median / High Price $172.96 / $327.20 / $578.59	Professional		$172.96	$327.20	$578.59
United Facility/Professional Facility Modifier Low / Median / High Price $2,367.00 / $3,088.30 / $4,295.00	Facility		$2,367.00	$3,088.30	$4,295.00
United Facility/Professional Professional Modifier Low / Median / High Price $89.55 / $178.59 / $371.05	Professional		$89.55	$178.59	$371.05