Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $55.89 / $338.66 / $1,894.00	Facility		$55.89	$338.66	$1,894.00
Aetna Facility/Professional Facility Modifier 53 Low / Median / High Price $11.18 / $17.87 / $31.84	Facility	53	$11.18	$17.87	$31.84
Aetna Facility/Professional Professional Modifier Low / Median / High Price $40.97 / $63.24 / $497.25	Professional		$40.97	$63.24	$497.25
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $1,139.00 / $1,183.00 / $1,530.00	Facility		$1,139.00	$1,183.00	$1,530.00
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $43.94 / $108.03 / $272.30	Professional		$43.94	$108.03	$272.30
CareSource Facility/Professional Facility Modifier Low / Median / High Price $41.21 / $62.48 / $62.48	Facility		$41.21	$62.48	$62.48
CareSource Facility/Professional Professional Modifier Low / Median / High Price $62.48 / $85.80 / $96.56	Professional		$62.48	$85.80	$96.56
Cigna Facility/Professional Facility Modifier Low / Median / High Price $112.64 / $131.63 / $212.31	Facility		$112.64	$131.63	$212.31
Cigna Facility/Professional Professional Modifier Low / Median / High Price $81.79 / $135.61 / $202.24	Professional		$81.79	$135.61	$202.24
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $43.67 / $69.48 / $135.02	Facility		$43.67	$69.48	$135.02
Medica Facility/Professional Facility Modifier Low / Median / High Price $47.77 / $1,100.00 / $2,090.40	Facility		$47.77	$1,100.00	$2,090.40
Medica Facility/Professional Professional Modifier Low / Median / High Price $54.18 / $147.29 / $257.31	Professional		$54.18	$147.29	$257.31
Molina Facility/Professional Professional Modifier Low / Median / High Price $27.68 / $68.51 / $148.13	Professional		$27.68	$68.51	$148.13
Prevea360 Facility/Professional Facility Modifier Low / Median / High Price $43.67 / $69.48 / $135.02	Facility		$43.67	$69.48	$135.02
Quartz Facility/Professional Professional Modifier Low / Median / High Price $83.85 / $129.47 / $182.32	Professional		$83.85	$129.47	$182.32
Quartz Facility/Professional Facility Modifier Low / Median / High Price $1,300.00 / $1,300.00 / $1,300.00	Facility		$1,300.00	$1,300.00	$1,300.00
Quartz Facility/Professional Facility Modifier 53 Low / Median / High Price $50.00 / $50.00 / $50.00	Facility	53	$50.00	$50.00	$50.00
Quartz Facility/Professional Professional Modifier Low / Median / High Price $84.40 / $222.03 / $543.00	Professional		$84.40	$222.03	$543.00
Security Health Facility/Professional Professional Modifier Low / Median / High Price $156.32 / $303.86 / $303.86	Professional		$156.32	$303.86	$303.86
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 $52.37 / $144.00 / $212.91	Professional		$52.37	$144.00	$212.91