Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $159.93 / $2,147.19 / $6,630.94	Facility		$159.93	$2,147.19	$6,630.94
Aetna Facility/Professional Facility Modifier 52 Low / Median / High Price $79.97 / $155.99 / $472.40	Facility	52	$79.97	$155.99	$472.40
Aetna Facility/Professional Professional Modifier Low / Median / High Price $10.43 / $272.56 / $1,151.75	Professional		$10.43	$272.56	$1,151.75
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 $219.50 / $506.96 / $1,381.51	Professional		$219.50	$506.96	$1,381.51
CareSource Facility/Professional Facility Modifier Low / Median / High Price $124.62 / $187.88 / $187.88	Facility		$124.62	$187.88	$187.88
CareSource Facility/Professional Professional Modifier Low / Median / High Price $242.96 / $343.05 / $530.24	Professional		$242.96	$343.05	$530.24
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 $223.51 / $460.31 / $901.49	Professional		$223.51	$460.31	$901.49
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $154.57 / $264.19 / $506.56	Facility		$154.57	$264.19	$506.56
Medica Facility/Professional Facility Modifier Low / Median / High Price $159.93 / $482.12 / $5,639.00	Facility		$159.93	$482.12	$5,639.00
Medica Facility/Professional Professional Modifier Low / Median / High Price $293.83 / $872.04 / $1,737.62	Professional		$293.83	$872.04	$1,737.62
Molina Facility/Professional Professional Modifier Low / Median / High Price $85.00 / $423.27 / $664.74	Professional		$85.00	$423.27	$664.74
Prevea360 Facility/Professional Facility Modifier Low / Median / High Price $154.57 / $264.19 / $506.56	Facility		$154.57	$264.19	$506.56
Quartz Facility/Professional Professional Modifier Low / Median / High Price $300.74 / $542.91 / $904.46	Professional		$300.74	$542.91	$904.46
Quartz Facility/Professional Facility Modifier Low / Median / High Price $1,076.46 / $1,076.46 / $1,076.46	Facility		$1,076.46	$1,076.46	$1,076.46
Quartz Facility/Professional Facility Modifier 52 Low / Median / High Price $477.18 / $477.18 / $477.18	Facility	52	$477.18	$477.18	$477.18
Quartz Facility/Professional Professional Modifier Low / Median / High Price $187.09 / $1,089.63 / $6,313.62	Professional		$187.09	$1,089.63	$6,313.62
Security Health Facility/Professional Professional Modifier Low / Median / High Price $630.49 / $790.53 / $1,548.24	Professional		$630.49	$790.53	$1,548.24
United Facility/Professional Facility Modifier Low / Median / High Price $2,960.00 / $4,409.38 / $5,865.00	Facility		$2,960.00	$4,409.38	$5,865.00
United Facility/Professional Professional Modifier Low / Median / High Price $293.83 / $818.76 / $1,094.52	Professional		$293.83	$818.76	$1,094.52