Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $46.45 / $151.02 / $1,894.00	Facility		$46.45	$151.02	$1,894.00
Aetna Facility/Professional Facility Modifier 50 Low / Median / High Price $439.12 / $439.12 / $709.20	Facility	50	$439.12	$439.12	$709.20
Aetna Facility/Professional Professional Modifier Low / Median / High Price $50.67 / $98.97 / $416.00	Professional		$50.67	$98.97	$416.00
Aetna Facility/Professional Professional Modifier 50 Low / Median / High Price $135.13 / $778.50 / $1,236.75	Professional	50	$135.13	$778.50	$1,236.75
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 $62.44 / $113.75 / $299.76	Professional		$62.44	$113.75	$299.76
Anthem BCBS Facility/Professional Professional Modifier 50 Low / Median / High Price $98.13 / $170.62 / $449.64	Professional	50	$98.13	$170.62	$449.64
CareSource Facility/Professional Facility Modifier Low / Median / High Price $50.43 / $60.52 / $77.81	Facility		$50.43	$60.52	$77.81
CareSource Facility/Professional Professional Modifier Low / Median / High Price $66.95 / $70.31 / $95.75	Professional		$66.95	$70.31	$95.75
Cigna Facility/Professional Facility Modifier Low / Median / High Price $193.74 / $226.40 / $347.31	Facility		$193.74	$226.40	$347.31
Cigna Facility/Professional Professional Modifier Low / Median / High Price $88.76 / $187.83 / $324.95	Professional		$88.76	$187.83	$324.95
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $48.93 / $79.06 / $151.02	Facility		$48.93	$79.06	$151.02
Medica Facility/Professional Facility Modifier Low / Median / High Price $54.59 / $98.91 / $1,449.00	Facility		$54.59	$98.91	$1,449.00
Medica Facility/Professional Facility Modifier 50 Low / Median / High Price $774.48 / $774.75 / $912.60	Facility	50	$774.48	$774.75	$912.60
Medica Facility/Professional Professional Modifier Low / Median / High Price $91.93 / $182.70 / $1,157.00	Professional		$91.93	$182.70	$1,157.00
Molina Facility/Professional Professional Modifier Low / Median / High Price $41.03 / $85.00 / $169.27	Professional		$41.03	$85.00	$169.27
Prevea360 Facility/Professional Facility Modifier Low / Median / High Price $48.93 / $76.40 / $151.02	Facility		$48.93	$76.40	$151.02
Quartz Facility/Professional Professional Modifier Low / Median / High Price $121.25 / $173.27 / $268.38	Professional		$121.25	$173.27	$268.38
Quartz Facility/Professional Facility Modifier Low / Median / High Price $73.77 / $73.77 / $240.69	Facility		$73.77	$73.77	$240.69
Quartz Facility/Professional Professional Modifier Low / Median / High Price $114.12 / $272.83 / $1,157.00	Professional		$114.12	$272.83	$1,157.00
Security Health Facility/Professional Professional Modifier Low / Median / High Price $169.22 / $291.99 / $428.25	Professional		$169.22	$291.99	$428.25
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 $80.70 / $157.86 / $336.74	Professional		$80.70	$157.86	$336.74