Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $110.94 / $389.67 / $1,894.00	Facility		$110.94	$389.67	$1,894.00
Aetna Facility/Professional Facility Modifier 52 Low / Median / High Price $33.63 / $63.16 / $182.07	Facility	52	$33.63	$63.16	$182.07
Aetna Facility/Professional Facility Modifier 53 Low / Median / High Price $13.45 / $25.26 / $72.83	Facility	53	$13.45	$25.26	$72.83
Aetna Facility/Professional Professional Modifier Low / Median / High Price $77.15 / $173.63 / $620.50	Professional		$77.15	$173.63	$620.50
Aetna Facility/Professional Professional Modifier 52 Low / Median / High Price $28.05 / $47.20 / $166.78	Professional	52	$28.05	$47.20	$166.78
Aetna Facility/Professional Professional Modifier 53 Low / Median / High Price $13.45 / $22.19 / $74.53	Professional	53	$13.45	$22.19	$74.53
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 $90.64 / $229.82 / $486.92	Professional		$90.64	$229.82	$486.92
CareSource Facility/Professional Facility Modifier Low / Median / High Price $59.97 / $91.73 / $91.73	Facility		$59.97	$91.73	$91.73
CareSource Facility/Professional Professional Modifier Low / Median / High Price $94.49 / $138.57 / $214.19	Professional		$94.49	$138.57	$214.19
Cigna Facility/Professional Facility Modifier Low / Median / High Price $266.73 / $311.70 / $502.76	Facility		$266.73	$311.70	$502.76
Cigna Facility/Professional Professional Modifier Low / Median / High Price $115.30 / $207.71 / $347.73	Professional		$115.30	$207.71	$347.73
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $67.25 / $109.06 / $195.24	Facility		$67.25	$109.06	$195.24
Medica Facility/Professional Facility Modifier Low / Median / High Price $71.86 / $140.91 / $1,778.00	Facility		$71.86	$140.91	$1,778.00
Medica Facility/Professional Professional Modifier Low / Median / High Price $113.52 / $307.68 / $488.17	Professional		$113.52	$307.68	$488.17
Molina Facility/Professional Professional Modifier Low / Median / High Price $59.63 / $145.72 / $255.92	Professional		$59.63	$145.72	$255.92
Prevea360 Facility/Professional Facility Modifier Low / Median / High Price $64.76 / $108.97 / $195.24	Facility		$64.76	$108.97	$195.24
Quartz Facility/Professional Professional Modifier Low / Median / High Price $144.15 / $231.57 / $338.38	Professional		$144.15	$231.57	$338.38
Quartz Facility/Professional Facility Modifier Low / Median / High Price $293.32 / $293.32 / $293.32	Facility		$293.32	$293.32	$293.32
Quartz Facility/Professional Facility Modifier 52 Low / Median / High Price $228.87 / $228.87 / $228.87	Facility	52	$228.87	$228.87	$228.87
Quartz Facility/Professional Facility Modifier 53 Low / Median / High Price $57.22 / $57.22 / $57.22	Facility	53	$57.22	$57.22	$57.22
Quartz Facility/Professional Professional Modifier Low / Median / High Price $115.54 / $427.68 / $753.20	Professional		$115.54	$427.68	$753.20
Security Health Facility/Professional Professional Modifier Low / Median / High Price $229.03 / $333.93 / $549.35	Professional		$229.03	$333.93	$549.35
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 $110.88 / $272.20 / $411.21	Professional		$110.88	$272.20	$411.21