Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $191.58 / $544.79 / $3,119.00	Facility		$191.58	$544.79	$3,119.00
Aetna Facility/Professional Facility Modifier 50 Low / Median / High Price $3,220.80 / $3,220.80 / $5,622.02	Facility	50	$3,220.80	$3,220.80	$5,622.02
Aetna Facility/Professional Professional Modifier Low / Median / High Price $166.27 / $313.55 / $1,134.60	Professional		$166.27	$313.55	$1,134.60
Aetna Facility/Professional Professional Modifier 50 Low / Median / High Price $1,080.14 / $1,473.43 / $2,683.86	Professional	50	$1,080.14	$1,473.43	$2,683.86
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $1,905.00 / $3,496.00 / $5,962.00	Facility		$1,905.00	$3,496.00	$5,962.00
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $206.23 / $434.81 / $1,179.17	Professional		$206.23	$434.81	$1,179.17
Anthem BCBS Facility/Professional Professional Modifier 50 Low / Median / High Price $312.32 / $669.03 / $1,768.75	Professional	50	$312.32	$669.03	$1,768.75
CareSource Facility/Professional Facility Modifier Low / Median / High Price $151.35 / $228.33 / $228.33	Facility		$151.35	$228.33	$228.33
CareSource Facility/Professional Professional Modifier Low / Median / High Price $250.36 / $359.24 / $555.26	Professional		$250.36	$359.24	$555.26
Cigna Facility/Professional Facility Modifier Low / Median / High Price $683.95 / $799.25 / $1,289.16	Facility		$683.95	$799.25	$1,289.16
Cigna Facility/Professional Professional Modifier Low / Median / High Price $259.14 / $550.87 / $902.34	Professional		$259.14	$550.87	$902.34
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $185.89 / $312.24 / $587.04	Facility		$185.89	$312.24	$587.04
Medica Facility/Professional Facility Modifier Low / Median / High Price $191.58 / $427.27 / $5,261.00	Facility		$191.58	$427.27	$5,261.00
Medica Facility/Professional Facility Modifier 50 Low / Median / High Price $1,838.94 / $1,838.94 / $1,838.94	Facility	50	$1,838.94	$1,838.94	$1,838.94
Medica Facility/Professional Professional Modifier Low / Median / High Price $302.10 / $861.24 / $3,338.00	Professional		$302.10	$861.24	$3,338.00
Molina Facility/Professional Professional Modifier Low / Median / High Price $85.00 / $436.79 / $664.74	Professional		$85.00	$436.79	$664.74
Prevea360 Facility/Professional Facility Modifier Low / Median / High Price $185.89 / $312.24 / $587.04	Facility		$185.89	$312.24	$587.04
Quartz Facility/Professional Professional Modifier Low / Median / High Price $368.38 / $607.59 / $941.11	Professional		$368.38	$607.59	$941.11
Quartz Facility/Professional Facility Modifier Low / Median / High Price $1,120.02 / $1,120.02 / $1,120.02	Facility		$1,120.02	$1,120.02	$1,120.02
Quartz Facility/Professional Professional Modifier Low / Median / High Price $221.11 / $1,090.67 / $3,411.19	Professional		$221.11	$1,090.67	$3,411.19
Security Health Facility/Professional Professional Modifier Low / Median / High Price $495.17 / $948.81 / $1,549.67	Professional		$495.17	$948.81	$1,549.67
United Facility/Professional Facility Modifier Low / Median / High Price $2,960.00 / $4,155.00 / $5,865.00	Facility		$2,960.00	$4,155.00	$5,865.00
United Facility/Professional Professional Modifier Low / Median / High Price $286.36 / $841.11 / $1,111.96	Professional		$286.36	$841.11	$1,111.96