Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $88.81 / $392.47 / $3,119.00	Facility		$88.81	$392.47	$3,119.00
Aetna Facility/Professional Facility Modifier 52 Low / Median / High Price $38.61 / $116.29 / $349.73	Facility	52	$38.61	$116.29	$349.73
Aetna Facility/Professional Professional Modifier Low / Median / High Price $71.14 / $245.35 / $1,080.00	Professional		$71.14	$245.35	$1,080.00
Aetna Facility/Professional Professional Modifier 52 Low / Median / High Price $35.46 / $104.24 / $349.73	Professional	52	$35.46	$104.24	$349.73
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 $85.63 / $268.91 / $860.22	Professional		$85.63	$268.91	$860.22
CareSource Facility/Professional Facility Modifier Low / Median / High Price $60.67 / $91.74 / $91.74	Facility		$60.67	$91.74	$91.74
CareSource Facility/Professional Professional Modifier Low / Median / High Price $178.72 / $249.00 / $384.88	Professional		$178.72	$249.00	$384.88
Cigna Facility/Professional Facility Modifier Low / Median / High Price $507.33 / $592.86 / $956.26	Facility		$507.33	$592.86	$956.26
Cigna Facility/Professional Professional Modifier Low / Median / High Price $105.91 / $259.89 / $661.16	Professional		$105.91	$259.89	$661.16
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $69.64 / $191.87 / $395.62	Facility		$69.64	$191.87	$395.62
Medica Facility/Professional Facility Modifier Low / Median / High Price $74.28 / $276.99 / $1,778.00	Facility		$74.28	$276.99	$1,778.00
Medica Facility/Professional Professional Modifier Low / Median / High Price $205.10 / $651.83 / $1,325.39	Professional		$205.10	$651.83	$1,325.39
Molina Facility/Professional Professional Modifier Low / Median / High Price $85.00 / $215.30 / $425.37	Professional		$85.00	$215.30	$425.37
Prevea360 Facility/Professional Facility Modifier Low / Median / High Price $69.64 / $191.87 / $395.62	Facility		$69.64	$191.87	$395.62
Quartz Facility/Professional Professional Modifier Low / Median / High Price $147.32 / $265.75 / $672.73	Professional		$147.32	$265.75	$672.73
Quartz Facility/Professional Facility Modifier Low / Median / High Price $451.14 / $451.14 / $451.14	Facility		$451.14	$451.14	$451.14
Quartz Facility/Professional Facility Modifier 52 Low / Median / High Price $233.74 / $233.74 / $233.74	Facility	52	$233.74	$233.74	$233.74
Quartz Facility/Professional Professional Modifier Low / Median / High Price $97.89 / $799.16 / $1,386.56	Professional		$97.89	$799.16	$1,386.56
Security Health Facility/Professional Professional Modifier Low / Median / High Price $185.69 / $381.88 / $1,135.49	Professional		$185.69	$381.88	$1,135.49
United Facility/Professional Facility Modifier Low / Median / High Price $785.00 / $1,370.00 / $2,202.90	Facility		$785.00	$1,370.00	$2,202.90
United Facility/Professional Professional Modifier Low / Median / High Price $205.10 / $638.75 / $834.86	Professional		$205.10	$638.75	$834.86