Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $91.23 / $404.51 / $3,812.18	Facility		$91.23	$404.51	$3,812.18
Aetna Facility/Professional Professional Modifier Low / Median / High Price $87.95 / $197.64 / $768.68	Professional		$87.95	$197.64	$768.68
Aetna Facility/Professional Professional Modifier 50 Low / Median / High Price $379.50 / $1,119.00 / $1,670.25	Professional	50	$379.50	$1,119.00	$1,670.25
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 $129.69 / $320.95 / $947.52	Professional		$129.69	$320.95	$947.52
Anthem BCBS Facility/Professional Professional Modifier 50 Low / Median / High Price $204.24 / $513.82 / $1,483.71	Professional	50	$204.24	$513.82	$1,483.71
CareSource Facility/Professional Facility Modifier Low / Median / High Price $71.18 / $109.94 / $109.94	Facility		$71.18	$109.94	$109.94
CareSource Facility/Professional Professional Modifier Low / Median / High Price $264.69 / $409.14 / $409.14	Professional		$264.69	$409.14	$409.14
Cigna Facility/Professional Facility Modifier Low / Median / High Price $529.86 / $619.17 / $998.72	Facility		$529.86	$619.17	$998.72
Cigna Facility/Professional Professional Modifier Low / Median / High Price $139.72 / $351.65 / $793.61	Professional		$139.72	$351.65	$793.61
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $71.78 / $141.72 / $386.53	Facility		$71.78	$141.72	$386.53
Medica Facility/Professional Facility Modifier Low / Median / High Price $81.67 / $306.06 / $1,789.00	Facility		$81.67	$306.06	$1,789.00
Medica Facility/Professional Professional Modifier Low / Median / High Price $219.76 / $569.28 / $1,107.78	Professional		$219.76	$569.28	$1,107.78
Molina Facility/Professional Professional Modifier Low / Median / High Price $114.10 / $209.92 / $471.74	Professional		$114.10	$209.92	$471.74
Prevea360 Facility/Professional Facility Modifier Low / Median / High Price $71.78 / $141.72 / $386.53	Facility		$71.78	$141.72	$386.53
Quartz Facility/Professional Professional Modifier Low / Median / High Price $171.71 / $323.14 / $673.41	Professional		$171.71	$323.14	$673.41
Quartz Facility/Professional Facility Modifier Low / Median / High Price $374.13 / $374.13 / $374.13	Facility		$374.13	$374.13	$374.13
Quartz Facility/Professional Professional Modifier Low / Median / High Price $137.88 / $768.29 / $1,466.96	Professional		$137.88	$768.29	$1,466.96
Security Health Facility/Professional Professional Modifier Low / Median / High Price $494.24 / $563.61 / $1,384.87	Professional		$494.24	$563.61	$1,384.87
United Facility/Professional Facility Modifier Low / Median / High Price $1,034.00 / $1,423.00 / $2,202.90	Facility		$1,034.00	$1,423.00	$2,202.90
United Facility/Professional Professional Modifier Low / Median / High Price $218.08 / $569.28 / $891.50	Professional		$218.08	$569.28	$891.50