Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $48.98 / $151.27 / $269.58	Facility		$48.98	$151.27	$269.58
Aetna Facility/Professional Professional Modifier Low / Median / High Price $47.06 / $81.19 / $367.00	Professional		$47.06	$81.19	$367.00
Aetna Facility/Professional Professional Modifier 52 Low / Median / High Price $22.95 / $40.04 / $131.26	Professional	52	$22.95	$40.04	$131.26
Aetna Facility/Professional Professional Modifier 53 Low / Median / High Price $8.17 / $13.82 / $39.27	Professional	53	$8.17	$13.82	$39.27
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 $61.19 / $162.68 / $349.49	Professional		$61.19	$162.68	$349.49
Cigna Facility/Professional Facility Modifier Low / Median / High Price $195.54 / $228.51 / $368.57	Facility		$195.54	$228.51	$368.57
Cigna Facility/Professional Professional Modifier Low / Median / High Price $81.84 / $146.84 / $250.64	Professional		$81.84	$146.84	$250.64
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $45.01 / $79.81 / $144.54	Facility		$45.01	$79.81	$144.54
Medica Facility/Professional Facility Modifier Low / Median / High Price $48.98 / $90.43 / $1,778.00	Facility		$48.98	$90.43	$1,778.00
Medica Facility/Professional Professional Modifier Low / Median / High Price $79.63 / $207.87 / $355.88	Professional		$79.63	$207.87	$355.88
Molina Facility/Professional Professional Modifier Low / Median / High Price $45.20 / $102.08 / $163.35	Professional		$45.20	$102.08	$163.35
Prevea360 Facility/Professional Facility Modifier Low / Median / High Price $40.92 / $73.95 / $144.54	Facility		$40.92	$73.95	$144.54
Quartz Facility/Professional Professional Modifier Low / Median / High Price $105.25 / $163.16 / $250.70	Professional		$105.25	$163.16	$250.70
Quartz Facility/Professional Facility Modifier Low / Median / High Price $208.92 / $208.92 / $208.92	Facility		$208.92	$208.92	$208.92
Quartz Facility/Professional Professional Modifier Low / Median / High Price $75.33 / $313.70 / $552.16	Professional		$75.33	$313.70	$552.16
Security Health Facility/Professional Professional Modifier Low / Median / High Price $123.79 / $242.74 / $402.98	Professional		$123.79	$242.74	$402.98
United Facility/Professional Facility Modifier Low / Median / High Price $1,008.00 / $1,423.00 / $2,202.90	Facility		$1,008.00	$1,423.00	$2,202.90
United Facility/Professional Professional Modifier Low / Median / High Price $77.86 / $164.55 / $288.45	Professional		$77.86	$164.55	$288.45