Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $112.95 / $320.51 / $759.92	Facility		$112.95	$320.51	$759.92
Aetna Facility/Professional Facility Modifier 50 Low / Median / High Price $891.80 / $3,182.50 / $3,182.50	Facility	50	$891.80	$3,182.50	$3,182.50
Aetna Facility/Professional Professional Modifier Low / Median / High Price $50.28 / $171.06 / $604.23	Professional		$50.28	$171.06	$604.23
Aetna Facility/Professional Professional Modifier 50 Low / Median / High Price $231.25 / $832.20 / $1,090.13	Professional	50	$231.25	$832.20	$1,090.13
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 $80.87 / $156.90 / $324.73	Professional		$80.87	$156.90	$324.73
Anthem BCBS Facility/Professional Professional Modifier 50 Low / Median / High Price $121.30 / $235.35 / $487.09	Professional	50	$121.30	$235.35	$487.09
CareSource Facility/Professional Facility Modifier Low / Median / High Price $53.68 / $82.16 / $82.16	Facility		$53.68	$82.16	$82.16
CareSource Facility/Professional Professional Modifier Low / Median / High Price $146.49 / $206.79 / $319.64	Professional		$146.49	$206.79	$319.64
Cigna Facility/Professional Facility Modifier Low / Median / High Price $419.92 / $490.71 / $791.50	Facility		$419.92	$490.71	$791.50
Cigna Facility/Professional Professional Modifier Low / Median / High Price $100.40 / $212.25 / $548.54	Professional		$100.40	$212.25	$548.54
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $60.24 / $107.93 / $270.88	Facility		$60.24	$107.93	$270.88
Medica Facility/Professional Facility Modifier Low / Median / High Price $64.25 / $230.50 / $1,756.00	Facility		$64.25	$230.50	$1,756.00
Medica Facility/Professional Facility Modifier 50 Low / Median / High Price $102.52 / $188.36 / $569.53	Facility	50	$102.52	$188.36	$569.53
Medica Facility/Professional Professional Modifier Low / Median / High Price $131.46 / $448.51 / $979.52	Professional		$131.46	$448.51	$979.52
Molina Facility/Professional Professional Modifier Low / Median / High Price $74.94 / $148.14 / $298.35	Professional		$74.94	$148.14	$298.35
Prevea360 Facility/Professional Facility Modifier Low / Median / High Price $56.25 / $107.93 / $270.88	Facility		$56.25	$107.93	$270.88
Quartz Facility/Professional Professional Modifier Low / Median / High Price $129.00 / $228.95 / $533.95	Professional		$129.00	$228.95	$533.95
Quartz Facility/Professional Facility Modifier Low / Median / High Price $392.88 / $392.88 / $392.88	Facility		$392.88	$392.88	$392.88
Quartz Facility/Professional Professional Modifier Low / Median / High Price $84.33 / $597.55 / $1,154.72	Professional		$84.33	$597.55	$1,154.72
Security Health Facility/Professional Professional Modifier Low / Median / High Price $154.74 / $328.97 / $942.05	Professional		$154.74	$328.97	$942.05
United Facility/Professional Facility Modifier Low / Median / High Price $1,008.00 / $1,423.00 / $2,202.90	Facility		$1,008.00	$1,423.00	$2,202.90
United Facility/Professional Professional Modifier Low / Median / High Price $131.52 / $469.77 / $762.82	Professional		$131.52	$469.77	$762.82