Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $44.56 / $324.87 / $1,241.22	Facility		$44.56	$324.87	$1,241.22
Aetna Facility/Professional Professional Modifier Low / Median / High Price $47.32 / $103.24 / $318.31	Professional		$47.32	$103.24	$318.31
Aetna Facility/Professional Professional Modifier 50 Low / Median / High Price $144.80 / $830.88 / $927.00	Professional	50	$144.80	$830.88	$927.00
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 $64.45 / $130.04 / $328.02	Professional		$64.45	$130.04	$328.02
Anthem BCBS Facility/Professional Professional Modifier 50 Low / Median / High Price $105.70 / $195.06 / $492.03	Professional	50	$105.70	$195.06	$492.03
CareSource Facility/Professional Facility Modifier Low / Median / High Price $49.25 / $59.10 / $75.48	Facility		$49.25	$59.10	$75.48
CareSource Facility/Professional Professional Modifier Low / Median / High Price $99.43 / $104.40 / $138.36	Professional		$99.43	$104.40	$138.36
Cigna Facility/Professional Facility Modifier Low / Median / High Price $300.07 / $350.66 / $537.91	Facility		$300.07	$350.66	$537.91
Cigna Facility/Professional Professional Modifier Low / Median / High Price $91.61 / $210.31 / $497.06	Professional		$91.61	$210.31	$497.06
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $45.39 / $101.11 / $185.83	Facility		$45.39	$101.11	$185.83
Medica Facility/Professional Facility Modifier Low / Median / High Price $51.99 / $121.33 / $1,368.00	Facility		$51.99	$121.33	$1,368.00
Medica Facility/Professional Facility Modifier 50 Low / Median / High Price $595.35 / $595.35 / $654.75	Facility	50	$595.35	$595.35	$654.75
Medica Facility/Professional Professional Modifier Low / Median / High Price $119.06 / $258.19 / $1,030.00	Professional		$119.06	$258.19	$1,030.00
Molina Facility/Professional Professional Modifier Low / Median / High Price $58.91 / $110.23 / $235.87	Professional		$58.91	$110.23	$235.87
Prevea360 Facility/Professional Facility Modifier Low / Median / High Price $46.07 / $101.11 / $185.83	Facility		$46.07	$101.11	$185.83
Quartz Facility/Professional Professional Modifier Low / Median / High Price $119.74 / $219.05 / $378.86	Professional		$119.74	$219.05	$378.86
Quartz Facility/Professional Facility Modifier Low / Median / High Price $160.19 / $160.19 / $237.65	Facility		$160.19	$160.19	$237.65
Quartz Facility/Professional Professional Modifier Low / Median / High Price $124.59 / $475.43 / $1,030.00	Professional		$124.59	$475.43	$1,030.00
Security Health Facility/Professional Professional Modifier Low / Median / High Price $249.68 / $376.86 / $654.95	Professional		$249.68	$376.86	$654.95
United Facility/Professional Facility Modifier Low / Median / High Price $1,034.00 / $1,590.00 / $2,202.90	Facility		$1,034.00	$1,590.00	$2,202.90
United Facility/Professional Professional Modifier Low / Median / High Price $115.57 / $219.92 / $461.02	Professional		$115.57	$219.92	$461.02