Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $37.15 / $183.22 / $569.01	Facility		$37.15	$183.22	$569.01
Aetna Facility/Professional Facility Modifier 50 Low / Median / High Price $416.94 / $688.20 / $790.40	Facility	50	$416.94	$688.20	$790.40
Aetna Facility/Professional Professional Modifier Low / Median / High Price $27.28 / $84.89 / $218.61	Professional		$27.28	$84.89	$218.61
Aetna Facility/Professional Professional Modifier 50 Low / Median / High Price $122.14 / $233.78 / $464.13	Professional	50	$122.14	$233.78	$464.13
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 $32.82 / $73.14 / $157.65	Professional		$32.82	$73.14	$157.65
Anthem BCBS Facility/Professional Professional Modifier 50 Low / Median / High Price $51.84 / $115.23 / $245.20	Professional	50	$51.84	$115.23	$245.20
CareSource Facility/Professional Facility Modifier Low / Median / High Price $25.05 / $30.70 / $183.68	Facility		$25.05	$30.70	$183.68
CareSource Facility/Professional Professional Modifier Low / Median / High Price $79.20 / $83.17 / $107.02	Professional		$79.20	$83.17	$107.02
Cigna Facility/Professional Facility Modifier Low / Median / High Price $241.50 / $282.20 / $432.92	Facility		$241.50	$282.20	$432.92
Cigna Facility/Professional Professional Modifier Low / Median / High Price $48.67 / $125.43 / $399.45	Professional		$48.67	$125.43	$399.45
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $27.28 / $81.43 / $184.51	Facility		$27.28	$81.43	$184.51
Medica Facility/Professional Facility Modifier Low / Median / High Price $27.46 / $97.72 / $1,449.00	Facility		$27.46	$97.72	$1,449.00
Medica Facility/Professional Facility Modifier 50 Low / Median / High Price $244.20 / $244.20 / $244.20	Facility	50	$244.20	$244.20	$244.20
Medica Facility/Professional Professional Modifier Low / Median / High Price $89.05 / $191.93 / $545.92	Professional		$89.05	$191.93	$545.92
Molina Facility/Professional Professional Modifier Low / Median / High Price $58.40 / $95.42 / $224.24	Professional		$58.40	$95.42	$224.24
Prevea360 Facility/Professional Facility Modifier Low / Median / High Price $27.28 / $81.43 / $184.51	Facility		$27.28	$81.43	$184.51
Quartz Facility/Professional Professional Modifier Low / Median / High Price $60.30 / $114.90 / $293.42	Professional		$60.30	$114.90	$293.42
Quartz Facility/Professional Facility Modifier Low / Median / High Price $132.91 / $132.91 / $157.82	Facility		$132.91	$132.91	$157.82
Quartz Facility/Professional Professional Modifier Low / Median / High Price $60.10 / $324.12 / $659.52	Professional		$60.10	$324.12	$659.52
Security Health Facility/Professional Professional Modifier Low / Median / High Price $92.08 / $175.67 / $576.59	Professional		$92.08	$175.67	$576.59
United Facility/Professional Facility Modifier Low / Median / High Price $785.00 / $1,297.00 / $2,202.90	Facility		$785.00	$1,297.00	$2,202.90
United Facility/Professional Professional Modifier Low / Median / High Price $89.05 / $152.59 / $398.76	Professional		$89.05	$152.59	$398.76