Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $60.49 / $129.56 / $453.86	Facility		$60.49	$129.56	$453.86
Aetna Facility/Professional Professional Modifier Low / Median / High Price $60.49 / $103.58 / $465.48	Professional		$60.49	$103.58	$465.48
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 $76.62 / $139.59 / $350.28	Professional		$76.62	$139.59	$350.28
Anthem BCBS Facility/Professional Professional Modifier 50 Low / Median / High Price $120.09 / $209.38 / $549.09	Professional	50	$120.09	$209.38	$549.09
CareSource Facility/Professional Facility Modifier Low / Median / High Price $59.72 / $75.59 / $154.90	Facility		$59.72	$75.59	$154.90
CareSource Facility/Professional Professional Modifier Low / Median / High Price $81.70 / $85.79 / $113.76	Professional		$81.70	$85.79	$113.76
Cigna Facility/Professional Facility Modifier Low / Median / High Price $236.99 / $276.95 / $424.84	Facility		$236.99	$276.95	$424.84
Cigna Facility/Professional Professional Modifier Low / Median / High Price $97.68 / $229.17 / $387.91	Professional		$97.68	$229.17	$387.91
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $60.49 / $92.13 / $186.62	Facility		$60.49	$92.13	$186.62
Medica Facility/Professional Facility Modifier Low / Median / High Price $60.49 / $107.77 / $1,449.00	Facility		$60.49	$107.77	$1,449.00
Medica Facility/Professional Professional Modifier Low / Median / High Price $93.69 / $206.29 / $659.04	Professional		$93.69	$206.29	$659.04
Molina Facility/Professional Professional Modifier Low / Median / High Price $58.91 / $110.23 / $235.87	Professional		$58.91	$110.23	$235.87
Prevea360 Facility/Professional Facility Modifier Low / Median / High Price $60.49 / $90.74 / $186.62	Facility		$60.49	$90.74	$186.62
Quartz Facility/Professional Professional Modifier Low / Median / High Price $147.18 / $209.91 / $309.16	Professional		$147.18	$209.91	$309.16
Quartz Facility/Professional Facility Modifier Low / Median / High Price $120.96 / $120.96 / $293.83	Facility		$120.96	$120.96	$293.83
Quartz Facility/Professional Professional Modifier Low / Median / High Price $129.81 / $376.52 / $659.04	Professional		$129.81	$376.52	$659.04
Security Health Facility/Professional Professional Modifier Low / Median / High Price $193.07 / $395.80 / $569.19	Professional		$193.07	$395.80	$569.19
United Facility/Professional Facility Modifier Low / Median / High Price $875.66 / $1,297.00 / $2,202.90	Facility		$875.66	$1,297.00	$2,202.90
United Facility/Professional Professional Modifier Low / Median / High Price $88.45 / $167.79 / $371.74	Professional		$88.45	$167.79	$371.74