Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $138.16 / $719.15 / $2,840.79	Facility		$138.16	$719.15	$2,840.79
Aetna Facility/Professional Professional Modifier Low / Median / High Price $66.45 / $229.03 / $959.00	Professional		$66.45	$229.03	$959.00
Aetna Facility/Professional Professional Modifier 50 Low / Median / High Price $3,405.15 / $3,405.15 / $3,405.15	Professional	50	$3,405.15	$3,405.15	$3,405.15
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 $85.28 / $196.22 / $457.47	Professional		$85.28	$196.22	$457.47
Anthem BCBS Facility/Professional Professional Modifier 50 Low / Median / High Price $148.54 / $294.33 / $693.03	Professional	50	$148.54	$294.33	$693.03
CareSource Facility/Professional Facility Modifier Low / Median / High Price $61.56 / $83.45 / $105.90	Facility		$61.56	$83.45	$105.90
CareSource Facility/Professional Professional Modifier Low / Median / High Price $210.88 / $261.08 / $532.23	Professional		$210.88	$261.08	$532.23
Cigna Facility/Professional Facility Modifier Low / Median / High Price $625.38 / $730.80 / $971.30	Facility		$625.38	$730.80	$971.30
Cigna Facility/Professional Professional Modifier Low / Median / High Price $95.81 / $304.93 / $1,061.60	Professional		$95.81	$304.93	$1,061.60
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $68.48 / $183.50 / $450.15	Facility		$68.48	$183.50	$450.15
Medica Facility/Professional Facility Modifier Low / Median / High Price $71.84 / $247.91 / $1,449.00	Facility		$71.84	$247.91	$1,449.00
Medica Facility/Professional Professional Modifier Low / Median / High Price $246.84 / $871.17 / $3,229.91	Professional		$246.84	$871.17	$3,229.91
Molina Facility/Professional Professional Modifier Low / Median / High Price $112.40 / $198.02 / $474.86	Professional		$112.40	$198.02	$474.86
Prevea360 Facility/Professional Facility Modifier Low / Median / High Price $68.48 / $183.50 / $450.15	Facility		$68.48	$183.50	$450.15
Quartz Facility/Professional Professional Modifier Low / Median / High Price $154.83 / $318.70 / $741.20	Professional		$154.83	$318.70	$741.20
Quartz Facility/Professional Facility Modifier Low / Median / High Price $173.18 / $954.09 / $2,922.50	Facility		$173.18	$954.09	$2,922.50
Quartz Facility/Professional Professional Modifier Low / Median / High Price $144.76 / $954.09 / $3,229.91	Professional		$144.76	$954.09	$3,229.91
Security Health Facility/Professional Professional Modifier Low / Median / High Price $230.88 / $426.99 / $1,486.80	Professional		$230.88	$426.99	$1,486.80
United Facility/Professional Facility Modifier Low / Median / High Price $1,008.00 / $1,533.00 / $2,202.90	Facility		$1,008.00	$1,533.00	$2,202.90
United Facility/Professional Professional Modifier Low / Median / High Price $93.00 / $595.98 / $1,444.81	Professional		$93.00	$595.98	$1,444.81