Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $53.07 / $74.50 / $286.80	Facility		$53.07	$74.50	$286.80
Aetna Facility/Professional Professional Modifier Low / Median / High Price $53.51 / $85.85 / $335.00	Professional		$53.51	$85.85	$335.00
Aetna Facility/Professional Professional Modifier 50 Low / Median / High Price $118.88 / $118.88 / $722.40	Professional	50	$118.88	$118.88	$722.40
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 $68.34 / $122.47 / $313.58	Professional		$68.34	$122.47	$313.58
Anthem BCBS Facility/Professional Professional Modifier 50 Low / Median / High Price $106.84 / $183.70 / $486.51	Professional	50	$106.84	$183.70	$486.51
CareSource Facility/Professional Facility Modifier Low / Median / High Price $129.08 / $129.08 / $129.08	Facility		$129.08	$129.08	$129.08
Cigna Facility/Professional Facility Modifier Low / Median / High Price $204.55 / $239.04 / $366.69	Facility		$204.55	$239.04	$366.69
Cigna Facility/Professional Professional Modifier Low / Median / High Price $90.34 / $198.20 / $351.36	Professional		$90.34	$198.20	$351.36
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $53.51 / $87.17 / $160.91	Facility		$53.51	$87.17	$160.91
Medica Facility/Professional Facility Modifier Low / Median / High Price $59.25 / $108.00 / $1,449.00	Facility		$59.25	$108.00	$1,449.00
Medica Facility/Professional Professional Modifier Low / Median / High Price $88.55 / $190.58 / $569.67	Professional		$88.55	$190.58	$569.67
Molina Facility/Professional Professional Modifier Low / Median / High Price $41.03 / $85.00 / $167.21	Professional		$41.03	$85.00	$167.21
Prevea360 Facility/Professional Facility Modifier Low / Median / High Price $53.51 / $87.17 / $160.91	Facility		$53.51	$87.17	$160.91
Quartz Facility/Professional Professional Modifier Low / Median / High Price $125.83 / $178.61 / $263.06	Professional		$125.83	$178.61	$263.06
Quartz Facility/Professional Facility Modifier Low / Median / High Price $95.71 / $95.71 / $254.92	Facility		$95.71	$95.71	$254.92
Quartz Facility/Professional Professional Modifier Low / Median / High Price $114.66 / $325.49 / $569.67	Professional		$114.66	$325.49	$569.67
Security Health Facility/Professional Professional Modifier Low / Median / High Price $168.19 / $346.84 / $492.07	Professional		$168.19	$346.84	$492.07
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 $86.16 / $153.12 / $335.71	Professional		$86.16	$153.12	$335.71