Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $41.20 / $91.60 / $1,894.00	Facility		$41.20	$91.60	$1,894.00
Aetna Facility/Professional Professional Modifier Low / Median / High Price $41.20 / $84.09 / $313.82	Professional		$41.20	$84.09	$313.82
Aetna Facility/Professional Professional Modifier 50 Low / Median / High Price $646.98 / $646.98 / $646.98	Professional	50	$646.98	$646.98	$646.98
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 $65.16 / $115.31 / $331.23	Professional		$65.16	$115.31	$331.23
Anthem BCBS Facility/Professional Professional Modifier 50 Low / Median / High Price $97.74 / $172.96 / $496.84	Professional	50	$97.74	$172.96	$496.84
Cigna Facility/Professional Facility Modifier Low / Median / High Price $217.17 / $253.78 / $389.31	Facility		$217.17	$253.78	$389.31
Cigna Facility/Professional Professional Modifier Low / Median / High Price $87.00 / $171.69 / $361.46	Professional		$87.00	$171.69	$361.46
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $43.64 / $87.53 / $165.87	Facility		$43.64	$87.53	$165.87
Medica Facility/Professional Facility Modifier Low / Median / High Price $48.20 / $96.24 / $1,449.00	Facility		$48.20	$96.24	$1,449.00
Medica Facility/Professional Professional Modifier Low / Median / High Price $93.53 / $200.52 / $1,017.00	Professional		$93.53	$200.52	$1,017.00
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 $43.91 / $82.70 / $165.87	Facility		$43.91	$82.70	$165.87
Quartz Facility/Professional Professional Modifier Low / Median / High Price $103.73 / $177.22 / $287.30	Professional		$103.73	$177.22	$287.30
Quartz Facility/Professional Facility Modifier Low / Median / High Price $103.68 / $103.68 / $271.36	Facility		$103.68	$103.68	$271.36
Quartz Facility/Professional Professional Modifier Low / Median / High Price $103.51 / $268.58 / $1,017.00	Professional		$103.51	$268.58	$1,017.00
Security Health Facility/Professional Professional Modifier Low / Median / High Price $257.07 / $372.65 / $476.27	Professional		$257.07	$372.65	$476.27
United Facility/Professional Facility Modifier Low / Median / High Price $1,034.00 / $1,423.00 / $2,202.90	Facility		$1,034.00	$1,423.00	$2,202.90
United Facility/Professional Professional Modifier Low / Median / High Price $78.52 / $177.92 / $369.45	Professional		$78.52	$177.92	$369.45