Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $153.19 / $1,538.88 / $11,907.20	Facility		$153.19	$1,538.88	$11,907.20
Aetna Facility/Professional Professional Modifier Low / Median / High Price $71.64 / $169.90 / $935.59	Professional		$71.64	$169.90	$935.59
Aetna Facility/Professional Professional Modifier 50 Low / Median / High Price $689.33 / $689.33 / $1,571.75	Professional	50	$689.33	$689.33	$1,571.75
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 $134.69 / $316.25 / $820.88	Professional		$134.69	$316.25	$820.88
Anthem BCBS Facility/Professional Professional Modifier 50 Low / Median / High Price $214.93 / $494.34 / $1,241.55	Professional	50	$214.93	$494.34	$1,241.55
CareSource Facility/Professional Facility Modifier Low / Median / High Price $70.08 / $105.47 / $105.47	Facility		$70.08	$105.47	$105.47
CareSource Facility/Professional Professional Modifier Low / Median / High Price $165.66 / $231.35 / $357.59	Professional		$165.66	$231.35	$357.59
Cigna Facility/Professional Facility Modifier Low / Median / High Price $474.89 / $554.95 / $895.11	Facility		$474.89	$554.95	$895.11
Cigna Facility/Professional Professional Modifier Low / Median / High Price $140.27 / $271.43 / $628.58	Professional		$140.27	$271.43	$628.58
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $72.36 / $156.16 / $276.76	Facility		$72.36	$156.16	$276.76
Medica Facility/Professional Facility Modifier Low / Median / High Price $81.70 / $346.73 / $6,150.00	Facility		$81.70	$346.73	$6,150.00
Medica Facility/Professional Professional Modifier Low / Median / High Price $184.39 / $490.66 / $930.63	Professional		$184.39	$490.66	$930.63
Molina Facility/Professional Professional Modifier Low / Median / High Price $85.00 / $186.05 / $395.19	Professional		$85.00	$186.05	$395.19
Prevea360 Facility/Professional Facility Modifier Low / Median / High Price $72.36 / $156.16 / $276.76	Facility		$72.36	$156.16	$276.76
Quartz Facility/Professional Professional Modifier Low / Median / High Price $169.45 / $342.91 / $618.34	Professional		$169.45	$342.91	$618.34
Quartz Facility/Professional Facility Modifier Low / Median / High Price $523.14 / $523.14 / $523.14	Facility		$523.14	$523.14	$523.14
Quartz Facility/Professional Professional Modifier Low / Median / High Price $144.78 / $397.06 / $1,307.44	Professional		$144.78	$397.06	$1,307.44
Security Health Facility/Professional Professional Modifier Low / Median / High Price $411.96 / $645.62 / $979.69	Professional		$411.96	$645.62	$979.69
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 $183.92 / $490.66 / $742.18	Professional		$183.92	$490.66	$742.18