Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $0.70 / $170.19 / $1,894.00	Facility		$0.70	$170.19	$1,894.00
Aetna Facility/Professional Facility Modifier 50 Low / Median / High Price $466.20 / $466.20 / $1,036.19	Facility	50	$466.20	$466.20	$1,036.19
Aetna Facility/Professional Professional Modifier Low / Median / High Price $30.59 / $77.92 / $187.00	Professional		$30.59	$77.92	$187.00
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $1,139.00 / $2,425.00 / $4,433.00	Facility		$1,139.00	$2,425.00	$4,433.00
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $46.96 / $122.28 / $328.15	Professional		$46.96	$122.28	$328.15
CareSource Facility/Professional Facility Modifier Low / Median / High Price $28.98 / $39.18 / $49.67	Facility		$28.98	$39.18	$49.67
CareSource Facility/Professional Professional Modifier Low / Median / High Price $77.72 / $96.23 / $196.15	Professional		$77.72	$96.23	$196.15
Cigna Facility/Professional Facility Modifier Low / Median / High Price $220.77 / $257.99 / $342.89	Facility		$220.77	$257.99	$342.89
Cigna Facility/Professional Professional Modifier Low / Median / High Price $46.89 / $111.08 / $293.19	Professional		$46.89	$111.08	$293.19
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $32.35 / $73.42 / $170.69	Facility		$32.35	$73.42	$170.69
Medica Facility/Professional Facility Modifier Low / Median / High Price $34.67 / $93.23 / $1,449.00	Facility		$34.67	$93.23	$1,449.00
Medica Facility/Professional Professional Modifier Low / Median / High Price $56.70 / $175.60 / $1,650.00	Professional		$56.70	$175.60	$1,650.00
Molina Facility/Professional Professional Modifier Low / Median / High Price $58.91 / $95.42 / $224.24	Professional		$58.91	$95.42	$224.24
Prevea360 Facility/Professional Facility Modifier Low / Median / High Price $32.35 / $75.64 / $170.69	Facility		$32.35	$75.64	$170.69
Quartz Facility/Professional Professional Modifier Low / Median / High Price $72.51 / $142.50 / $270.60	Professional		$72.51	$142.50	$270.60
Quartz Facility/Professional Facility Modifier Low / Median / High Price $81.47 / $143.82 / $2,922.50	Facility		$81.47	$143.82	$2,922.50
Quartz Facility/Professional Professional Modifier Low / Median / High Price $66.91 / $284.39 / $1,650.00	Professional		$66.91	$284.39	$1,650.00
Security Health Facility/Professional Professional Modifier Low / Median / High Price $173.06 / $225.19 / $456.95	Professional		$173.06	$225.19	$456.95
United Facility/Professional Facility Modifier Low / Median / High Price $1,034.00 / $1,533.00 / $2,202.90	Facility		$1,034.00	$1,533.00	$2,202.90
United Facility/Professional Professional Modifier Low / Median / High Price $67.14 / $164.44 / $333.37	Professional		$67.14	$164.44	$333.37