Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $115.81 / $1,105.27 / $5,941.42	Facility		$115.81	$1,105.27	$5,941.42
Aetna Facility/Professional Facility Modifier 52 Low / Median / High Price $30.58 / $103.20 / $342.78	Facility	52	$30.58	$103.20	$342.78
Aetna Facility/Professional Facility Modifier 53 Low / Median / High Price $12.23 / $41.28 / $137.11	Facility	53	$12.23	$41.28	$137.11
Aetna Facility/Professional Professional Modifier Low / Median / High Price $54.61 / $137.26 / $548.25	Professional		$54.61	$137.26	$548.25
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $1,139.00 / $2,419.00 / $4,441.52	Facility		$1,139.00	$2,419.00	$4,441.52
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $81.03 / $250.48 / $906.72	Professional		$81.03	$250.48	$906.72
CareSource Facility/Professional Facility Modifier Low / Median / High Price $53.32 / $66.66 / $80.12	Facility		$53.32	$66.66	$80.12
CareSource Facility/Professional Professional Modifier Low / Median / High Price $167.07 / $209.95 / $373.38	Professional		$167.07	$209.95	$373.38
Cigna Facility/Professional Facility Modifier Low / Median / High Price $507.33 / $592.86 / $909.46	Facility		$507.33	$592.86	$909.46
Cigna Facility/Professional Facility Modifier 52 Low / Median / High Price $76.54 / $76.54 / $76.54	Facility	52	$76.54	$76.54	$76.54
Cigna Facility/Professional Facility Modifier 53 Low / Median / High Price $19.14 / $19.14 / $19.14	Facility	53	$19.14	$19.14	$19.14
Cigna Facility/Professional Professional Modifier Low / Median / High Price $90.50 / $231.11 / $777.61	Professional		$90.50	$231.11	$777.61
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $58.17 / $141.00 / $325.04	Facility		$58.17	$141.00	$325.04
Medica Facility/Professional Facility Modifier Low / Median / High Price $58.24 / $168.22 / $2,247.00	Facility		$58.24	$168.22	$2,247.00
Medica Facility/Professional Facility Modifier 52 Low / Median / High Price $207.08 / $207.08 / $207.08	Facility	52	$207.08	$207.08	$207.08
Medica Facility/Professional Facility Modifier 53 Low / Median / High Price $51.77 / $51.77 / $51.77	Facility	53	$51.77	$51.77	$51.77
Medica Facility/Professional Professional Modifier Low / Median / High Price $162.80 / $551.34 / $1,376.00	Professional		$162.80	$551.34	$1,376.00
Molina Facility/Professional Professional Modifier Low / Median / High Price $84.57 / $223.96 / $446.58	Professional		$84.57	$223.96	$446.58
Prevea360 Facility/Professional Facility Modifier Low / Median / High Price $57.75 / $136.50 / $325.04	Facility		$57.75	$136.50	$325.04
Quartz Facility/Professional Professional Modifier Low / Median / High Price $127.70 / $254.96 / $632.53	Professional		$127.70	$254.96	$632.53
Quartz Facility/Professional Facility Modifier Low / Median / High Price $95.68 / $343.59 / $2,922.50	Facility		$95.68	$343.59	$2,922.50
Quartz Facility/Professional Facility Modifier 52 Low / Median / High Price $76.54 / $207.08 / $207.08	Facility	52	$76.54	$207.08	$207.08
Quartz Facility/Professional Facility Modifier 53 Low / Median / High Price $19.14 / $51.77 / $51.77	Facility	53	$19.14	$51.77	$51.77
Quartz Facility/Professional Professional Modifier Low / Median / High Price $119.70 / $698.93 / $1,376.00	Professional		$119.70	$698.93	$1,376.00
Security Health Facility/Professional Professional Modifier Low / Median / High Price $201.55 / $282.17 / $949.44	Professional		$201.55	$282.17	$949.44
United Facility/Professional Facility Modifier Low / Median / High Price $2,257.00 / $2,695.00 / $4,155.00	Facility		$2,257.00	$2,695.00	$4,155.00
United Facility/Professional Professional Modifier Low / Median / High Price $166.57 / $372.16 / $790.08	Professional		$166.57	$372.16	$790.08