Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $163.06 / $947.00 / $5,089.83	Facility		$163.06	$947.00	$5,089.83
Aetna Facility/Professional Facility Modifier 52 Low / Median / High Price $40.22 / $124.53 / $405.97	Facility	52	$40.22	$124.53	$405.97
Aetna Facility/Professional Facility Modifier 53 Low / Median / High Price $16.09 / $49.81 / $162.38	Facility	53	$16.09	$49.81	$162.38
Aetna Facility/Professional Professional Modifier Low / Median / High Price $80.43 / $298.36 / $1,243.88	Professional		$80.43	$298.36	$1,243.88
Aetna Facility/Professional Professional Modifier 52 Low / Median / High Price $40.22 / $108.87 / $211.48	Professional	52	$40.22	$108.87	$211.48
Aetna Facility/Professional Professional Modifier 53 Low / Median / High Price $16.09 / $43.55 / $91.12	Professional	53	$16.09	$43.55	$91.12
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 $148.94 / $392.03 / $1,126.78	Professional		$148.94	$392.03	$1,126.78
CareSource Facility/Professional Facility Modifier Low / Median / High Price $75.54 / $114.32 / $114.32	Facility		$75.54	$114.32	$114.32
CareSource Facility/Professional Professional Modifier Low / Median / High Price $207.74 / $289.98 / $448.24	Professional		$207.74	$289.98	$448.24
Cigna Facility/Professional Facility Modifier Low / Median / High Price $648.80 / $758.18 / $1,222.92	Facility		$648.80	$758.18	$1,222.92
Cigna Facility/Professional Professional Modifier Low / Median / High Price $144.93 / $301.70 / $863.55	Professional		$144.93	$301.70	$863.55
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $80.43 / $204.10 / $435.33	Facility		$80.43	$204.10	$435.33
Medica Facility/Professional Facility Modifier Low / Median / High Price $86.96 / $351.65 / $3,995.00	Facility		$86.96	$351.65	$3,995.00
Medica Facility/Professional Professional Modifier Low / Median / High Price $232.97 / $600.50 / $1,187.13	Professional		$232.97	$600.50	$1,187.13
Molina Facility/Professional Professional Modifier Low / Median / High Price $85.00 / $275.17 / $588.73	Professional		$85.00	$275.17	$588.73
Prevea360 Facility/Professional Facility Modifier Low / Median / High Price $80.43 / $202.48 / $435.33	Facility		$80.43	$202.48	$435.33
Quartz Facility/Professional Professional Modifier Low / Median / High Price $182.43 / $332.15 / $740.85	Professional		$182.43	$332.15	$740.85
Quartz Facility/Professional Facility Modifier Low / Median / High Price $407.55 / $407.55 / $407.55	Facility		$407.55	$407.55	$407.55
Quartz Facility/Professional Facility Modifier 52 Low / Median / High Price $289.45 / $289.45 / $289.45	Facility	52	$289.45	$289.45	$289.45
Quartz Facility/Professional Facility Modifier 53 Low / Median / High Price $72.36 / $72.36 / $72.36	Facility	53	$72.36	$72.36	$72.36
Quartz Facility/Professional Professional Modifier Low / Median / High Price $121.37 / $646.12 / $1,775.04	Professional		$121.37	$646.12	$1,775.04
Security Health Facility/Professional Professional Modifier Low / Median / High Price $468.16 / $601.59 / $1,436.93	Professional		$468.16	$601.59	$1,436.93
United Facility/Professional Facility Modifier Low / Median / High Price $2,367.00 / $3,068.00 / $4,985.00	Facility		$2,367.00	$3,068.00	$4,985.00
United Facility/Professional Professional Modifier Low / Median / High Price $232.97 / $560.40 / $964.69	Professional		$232.97	$560.40	$964.69