Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $55.85 / $476.14 / $1,717.90	Facility		$55.85	$476.14	$1,717.90
Aetna Facility/Professional Facility Modifier 52 Low / Median / High Price $27.93 / $62.74 / $263.88	Facility	52	$27.93	$62.74	$263.88
Aetna Facility/Professional Professional Modifier Low / Median / High Price $64.09 / $147.15 / $726.75	Professional		$64.09	$147.15	$726.75
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 $79.19 / $143.71 / $374.59	Professional		$79.19	$143.71	$374.59
CareSource Facility/Professional Facility Modifier Low / Median / High Price $61.49 / $73.79 / $95.30	Facility		$61.49	$73.79	$95.30
CareSource Facility/Professional Professional Modifier Low / Median / High Price $129.75 / $136.24 / $181.20	Professional		$129.75	$136.24	$181.20
Cigna Facility/Professional Facility Modifier Low / Median / High Price $384.78 / $449.64 / $689.77	Facility		$384.78	$449.64	$689.77
Cigna Facility/Professional Professional Modifier Low / Median / High Price $113.14 / $266.52 / $611.46	Professional		$113.14	$266.52	$611.46
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $56.26 / $123.80 / $286.33	Facility		$56.26	$123.80	$286.33
Medica Facility/Professional Facility Modifier Low / Median / High Price $61.30 / $143.59 / $2,930.60	Facility		$61.30	$143.59	$2,930.60
Medica Facility/Professional Professional Modifier Low / Median / High Price $157.51 / $315.95 / $1,142.11	Professional		$157.51	$315.95	$1,142.11
Molina Facility/Professional Professional Modifier Low / Median / High Price $77.22 / $135.30 / $315.53	Professional		$77.22	$135.30	$315.53
Prevea360 Facility/Professional Facility Modifier Low / Median / High Price $56.26 / $123.80 / $286.33	Facility		$56.26	$123.80	$286.33
Quartz Facility/Professional Professional Modifier Low / Median / High Price $147.19 / $284.37 / $492.40	Professional		$147.19	$284.37	$492.40
Quartz Facility/Professional Facility Modifier Low / Median / High Price $365.45 / $365.45 / $763.85	Facility		$365.45	$365.45	$763.85
Quartz Facility/Professional Facility Modifier 52 Low / Median / High Price $233.74 / $233.74 / $233.74	Facility	52	$233.74	$233.74	$233.74
Quartz Facility/Professional Professional Modifier Low / Median / High Price $149.00 / $568.83 / $1,142.11	Professional		$149.00	$568.83	$1,142.11
Security Health Facility/Professional Professional Modifier Low / Median / High Price $279.02 / $353.06 / $842.95	Professional		$279.02	$353.06	$842.95
United Facility/Professional Facility Modifier Low / Median / High Price $2,367.00 / $3,088.30 / $4,295.00	Facility		$2,367.00	$3,088.30	$4,295.00
United Facility/Professional Professional Modifier Low / Median / High Price $153.33 / $292.26 / $621.41	Professional		$153.33	$292.26	$621.41