Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $60.68 / $257.50 / $967.15	Facility		$60.68	$257.50	$967.15
Aetna Facility/Professional Professional Modifier Low / Median / High Price $30.18 / $86.10 / $388.00	Professional		$30.18	$86.10	$388.00
Aetna Facility/Professional Professional Modifier 52 Low / Median / High Price $15.09 / $39.26 / $78.40	Professional	52	$15.09	$39.26	$78.40
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 $55.89 / $142.52 / $365.53	Professional		$55.89	$142.52	$365.53
CareSource Facility/Professional Facility Modifier Low / Median / High Price $28.23 / $42.84 / $42.84	Facility		$28.23	$42.84	$42.84
CareSource Facility/Professional Professional Modifier Low / Median / High Price $71.63 / $100.56 / $155.44	Professional		$71.63	$100.56	$155.44
Cigna Facility/Professional Facility Modifier Low / Median / High Price $205.46 / $240.09 / $387.26	Facility		$205.46	$240.09	$387.26
Cigna Facility/Professional Professional Modifier Low / Median / High Price $55.55 / $121.69 / $275.31	Professional		$55.55	$121.69	$275.31
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $29.67 / $57.99 / $149.83	Facility		$29.67	$57.99	$149.83
Medica Facility/Professional Facility Modifier Low / Median / High Price $30.18 / $111.26 / $1,778.00	Facility		$30.18	$111.26	$1,778.00
Medica Facility/Professional Professional Modifier Low / Median / High Price $90.44 / $253.84 / $494.53	Professional		$90.44	$253.84	$494.53
Molina Facility/Professional Professional Modifier Low / Median / High Price $59.35 / $110.23 / $248.00	Professional		$59.35	$110.23	$248.00
Prevea360 Facility/Professional Facility Modifier Low / Median / High Price $26.97 / $57.99 / $149.83	Facility		$26.97	$57.99	$149.83
Quartz Facility/Professional Professional Modifier Low / Median / High Price $67.93 / $123.31 / $268.38	Professional		$67.93	$123.31	$268.38
Quartz Facility/Professional Facility Modifier Low / Median / High Price $140.79 / $140.79 / $140.79	Facility		$140.79	$140.79	$140.79
Quartz Facility/Professional Professional Modifier Low / Median / High Price $45.14 / $290.74 / $663.12	Professional		$45.14	$290.74	$663.12
Security Health Facility/Professional Professional Modifier Low / Median / High Price $174.11 / $211.11 / $458.13	Professional		$174.11	$211.11	$458.13
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 $86.83 / $255.43 / $361.11	Professional		$86.83	$255.43	$361.11