Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $165.58 / $540.53 / $2,812.39	Facility		$165.58	$540.53	$2,812.39
Aetna Facility/Professional Facility Modifier 50 Low / Median / High Price $1,399.46 / $1,399.46 / $1,399.46	Facility	50	$1,399.46	$1,399.46	$1,399.46
Aetna Facility/Professional Professional Modifier Low / Median / High Price $49.07 / $165.58 / $689.33	Professional		$49.07	$165.58	$689.33
Aetna Facility/Professional Professional Modifier 50 Low / Median / High Price $353.85 / $353.85 / $862.32	Professional	50	$353.85	$353.85	$862.32
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $1,139.00 / $1,183.00 / $1,530.00	Facility		$1,139.00	$1,183.00	$1,530.00
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $63.53 / $136.49 / $334.02	Professional		$63.53	$136.49	$334.02
Anthem BCBS Facility/Professional Professional Modifier 50 Low / Median / High Price $109.71 / $204.73 / $511.56	Professional	50	$109.71	$204.73	$511.56
CareSource Facility/Professional Facility Modifier Low / Median / High Price $45.25 / $60.96 / $77.47	Facility		$45.25	$60.96	$77.47
CareSource Facility/Professional Professional Modifier Low / Median / High Price $148.97 / $184.44 / $375.98	Professional		$148.97	$184.44	$375.98
Cigna Facility/Professional Facility Modifier Low / Median / High Price $438.85 / $512.83 / $681.59	Facility		$438.85	$512.83	$681.59
Cigna Facility/Professional Professional Modifier Low / Median / High Price $72.04 / $224.33 / $747.36	Professional		$72.04	$224.33	$747.36
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $49.22 / $139.10 / $266.08	Facility		$49.22	$139.10	$266.08
Medica Facility/Professional Facility Modifier Low / Median / High Price $53.15 / $174.58 / $1,449.00	Facility		$53.15	$174.58	$1,449.00
Medica Facility/Professional Professional Modifier Low / Median / High Price $173.02 / $570.24 / $1,786.65	Professional		$173.02	$570.24	$1,786.65
Molina Facility/Professional Professional Modifier Low / Median / High Price $93.96 / $158.49 / $395.19	Professional		$93.96	$158.49	$395.19
Prevea360 Facility/Professional Facility Modifier Low / Median / High Price $49.22 / $139.10 / $266.08	Facility		$49.22	$139.10	$266.08
Quartz Facility/Professional Professional Modifier Low / Median / High Price $112.88 / $232.36 / $519.20	Professional		$112.88	$232.36	$519.20
Quartz Facility/Professional Facility Modifier Low / Median / High Price $127.41 / $367.00 / $2,922.50	Facility		$127.41	$367.00	$2,922.50
Quartz Facility/Professional Professional Modifier Low / Median / High Price $107.50 / $605.41 / $1,786.65	Professional		$107.50	$605.41	$1,786.65
Security Health Facility/Professional Professional Modifier Low / Median / High Price $169.01 / $314.12 / $1,046.67	Professional		$169.01	$314.12	$1,046.67
United Facility/Professional Facility Modifier Low / Median / High Price $1,034.00 / $1,533.00 / $2,202.90	Facility		$1,034.00	$1,533.00	$2,202.90
United Facility/Professional Professional Modifier Low / Median / High Price $173.02 / $416.25 / $713.94	Professional		$173.02	$416.25	$713.94