Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $98.23 / $639.02 / $1,719.00	Facility		$98.23	$639.02	$1,719.00
Aetna Facility/Professional Facility Modifier 50 Low / Median / High Price $2,208.06 / $2,539.36 / $3,220.40	Facility	50	$2,208.06	$2,539.36	$3,220.40
Aetna Facility/Professional Professional Modifier Low / Median / High Price $57.72 / $131.33 / $761.90	Professional		$57.72	$131.33	$761.90
Aetna Facility/Professional Professional Modifier 50 Low / Median / High Price $142.88 / $777.26 / $1,236.75	Professional	50	$142.88	$777.26	$1,236.75
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 $86.04 / $188.91 / $452.59	Professional		$86.04	$188.91	$452.59
Anthem BCBS Facility/Professional Professional Modifier 50 Low / Median / High Price $132.63 / $283.36 / $681.64	Professional	50	$132.63	$283.36	$681.64
CareSource Facility/Professional Facility Modifier Low / Median / High Price $55.96 / $69.44 / $135.03	Facility		$55.96	$69.44	$135.03
CareSource Facility/Professional Professional Modifier Low / Median / High Price $89.39 / $93.86 / $124.74	Professional		$89.39	$93.86	$124.74
Cigna Facility/Professional Facility Modifier Low / Median / High Price $264.02 / $308.54 / $473.30	Facility		$264.02	$308.54	$473.30
Cigna Facility/Professional Professional Modifier Low / Median / High Price $99.03 / $231.42 / $447.29	Professional		$99.03	$231.42	$447.29
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $58.09 / $101.50 / $203.72	Facility		$58.09	$101.50	$203.72
Medica Facility/Professional Facility Modifier Low / Median / High Price $61.48 / $123.79 / $1,513.00	Facility		$61.48	$123.79	$1,513.00
Medica Facility/Professional Facility Modifier 50 Low / Median / High Price $641.54 / $660.78 / $971.89	Facility	50	$641.54	$660.78	$971.89
Medica Facility/Professional Professional Modifier Low / Median / High Price $106.98 / $217.27 / $739.52	Professional		$106.98	$217.27	$739.52
Medica Facility/Professional Professional Modifier 50 Low / Median / High Price $322.67 / $1,319.00 / $1,715.74	Professional	50	$322.67	$1,319.00	$1,715.74
Molina Facility/Professional Professional Modifier Low / Median / High Price $58.91 / $101.24 / $235.87	Professional		$58.91	$101.24	$235.87
Prevea360 Facility/Professional Facility Modifier Low / Median / High Price $58.09 / $101.50 / $203.72	Facility		$58.09	$101.50	$203.72
Quartz Facility/Professional Professional Modifier Low / Median / High Price $135.00 / $214.56 / $335.01	Professional		$135.00	$214.56	$335.01
Quartz Facility/Professional Facility Modifier Low / Median / High Price $114.33 / $114.33 / $267.93	Facility		$114.33	$114.33	$267.93
Quartz Facility/Professional Professional Modifier Low / Median / High Price $123.72 / $421.65 / $739.52	Professional		$123.72	$421.65	$739.52
Security Health Facility/Professional Professional Modifier Low / Median / High Price $215.94 / $370.91 / $637.45	Professional		$215.94	$370.91	$637.45
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 $99.97 / $183.88 / $415.40	Professional		$99.97	$183.88	$415.40