Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $156.13 / $474.66 / $5,717.36	Facility		$156.13	$474.66	$5,717.36
Aetna Facility/Professional Facility Modifier 52 Low / Median / High Price $78.06 / $151.01 / $462.01	Facility	52	$78.06	$151.01	$462.01
Aetna Facility/Professional Professional Modifier Low / Median / High Price $130.35 / $298.93 / $1,182.69	Professional		$130.35	$298.93	$1,182.69
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 $210.50 / $497.67 / $1,343.30	Professional		$210.50	$497.67	$1,343.30
CareSource Facility/Professional Facility Modifier Low / Median / High Price $123.35 / $186.68 / $186.68	Facility		$123.35	$186.68	$186.68
CareSource Facility/Professional Professional Modifier Low / Median / High Price $249.22 / $464.30 / $522.58	Professional		$249.22	$464.30	$522.58
Cigna Facility/Professional Facility Modifier Low / Median / High Price $665.03 / $777.14 / $1,253.49	Facility		$665.03	$777.14	$1,253.49
Cigna Facility/Professional Professional Modifier Low / Median / High Price $217.75 / $451.98 / $876.58	Professional		$217.75	$451.98	$876.58
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $151.51 / $258.99 / $495.42	Facility		$151.51	$258.99	$495.42
Medica Facility/Professional Facility Modifier Low / Median / High Price $156.13 / $362.66 / $5,261.00	Facility		$156.13	$362.66	$5,261.00
Medica Facility/Professional Professional Modifier Low / Median / High Price $283.83 / $835.22 / $1,664.25	Professional		$283.83	$835.22	$1,664.25
Molina Facility/Professional Professional Modifier Low / Median / High Price $85.00 / $422.43 / $664.74	Professional		$85.00	$422.43	$664.74
Prevea360 Facility/Professional Facility Modifier Low / Median / High Price $151.51 / $258.99 / $495.42	Facility		$151.51	$258.99	$495.42
Quartz Facility/Professional Professional Modifier Low / Median / High Price $297.69 / $521.91 / $889.09	Professional		$297.69	$521.91	$889.09
Quartz Facility/Professional Facility Modifier Low / Median / High Price $1,065.96 / $1,065.96 / $1,065.96	Facility		$1,065.96	$1,065.96	$1,065.96
Quartz Facility/Professional Facility Modifier 52 Low / Median / High Price $472.30 / $472.30 / $472.30	Facility	52	$472.30	$472.30	$472.30
Quartz Facility/Professional Professional Modifier Low / Median / High Price $180.89 / $1,059.53 / $1,853.04	Professional		$180.89	$1,059.53	$1,853.04
Security Health Facility/Professional Professional Modifier Low / Median / High Price $598.04 / $776.23 / $1,505.40	Professional		$598.04	$776.23	$1,505.40
United Facility/Professional Facility Modifier Low / Median / High Price $2,976.00 / $4,155.00 / $5,865.00	Facility		$2,976.00	$4,155.00	$5,865.00
United Facility/Professional Professional Modifier Low / Median / High Price $279.26 / $731.55 / $1,048.30	Professional		$279.26	$731.55	$1,048.30