Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $25.52 / $95.04 / $431.46	Facility		$25.52	$95.04	$431.46
Aetna Facility/Professional Facility Modifier 50 Low / Median / High Price $338.00 / $730.40 / $730.40	Facility	50	$338.00	$730.40	$730.40
Aetna Facility/Professional Professional Modifier Low / Median / High Price $26.41 / $53.86 / $141.43	Professional		$26.41	$53.86	$141.43
Aetna Facility/Professional Professional Modifier 50 Low / Median / High Price $77.36 / $346.89 / $355.50	Professional	50	$77.36	$346.89	$355.50
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 $35.78 / $60.70 / $160.34	Professional		$35.78	$60.70	$160.34
Anthem BCBS Facility/Professional Professional Modifier 50 Low / Median / High Price $57.04 / $91.05 / $240.51	Professional	50	$57.04	$91.05	$240.51
CareSource Facility/Professional Facility Modifier Low / Median / High Price $24.80 / $30.55 / $115.18	Facility		$24.80	$30.55	$115.18
CareSource Facility/Professional Professional Modifier Low / Median / High Price $56.91 / $59.76 / $78.22	Professional		$56.91	$59.76	$78.22
Cigna Facility/Professional Facility Modifier Low / Median / High Price $171.21 / $200.08 / $306.92	Facility		$171.21	$200.08	$306.92
Cigna Facility/Professional Professional Modifier Low / Median / High Price $47.08 / $106.48 / $277.49	Professional		$47.08	$106.48	$277.49
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $25.68 / $56.25 / $130.74	Facility		$25.68	$56.25	$130.74
Medica Facility/Professional Facility Modifier Low / Median / High Price $28.44 / $62.68 / $1,449.00	Facility		$28.44	$62.68	$1,449.00
Medica Facility/Professional Professional Modifier Low / Median / High Price $59.29 / $139.53 / $474.72	Professional		$59.29	$139.53	$474.72
Molina Facility/Professional Professional Modifier Low / Median / High Price $41.03 / $70.00 / $151.53	Professional		$41.03	$70.00	$151.53
Prevea360 Facility/Professional Facility Modifier Low / Median / High Price $25.68 / $56.25 / $130.74	Facility		$25.68	$56.25	$130.74
Quartz Facility/Professional Professional Modifier Low / Median / High Price $59.54 / $113.30 / $212.47	Professional		$59.54	$113.30	$212.47
Quartz Facility/Professional Facility Modifier Low / Median / High Price $85.07 / $85.07 / $118.08	Facility		$85.07	$85.07	$118.08
Quartz Facility/Professional Professional Modifier Low / Median / High Price $60.97 / $243.01 / $474.72	Professional		$60.97	$243.01	$474.72
Security Health Facility/Professional Professional Modifier Low / Median / High Price $79.47 / $164.46 / $411.57	Professional		$79.47	$164.46	$411.57
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 $59.46 / $118.05 / $267.74	Professional		$59.46	$118.05	$267.74