Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $64.63 / $534.47 / $3,452.68	Facility		$64.63	$534.47	$3,452.68
Aetna Facility/Professional Facility Modifier 50 Low / Median / High Price $3,397.27 / $3,397.27 / $3,397.27	Facility	50	$3,397.27	$3,397.27	$3,397.27
Aetna Facility/Professional Professional Modifier Low / Median / High Price $64.63 / $127.10 / $918.82	Professional		$64.63	$127.10	$918.82
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 $85.08 / $154.87 / $375.79	Professional		$85.08	$154.87	$375.79
Anthem BCBS Facility/Professional Professional Modifier 50 Low / Median / High Price $130.33 / $237.42 / $587.55	Professional	50	$130.33	$237.42	$587.55
CareSource Facility/Professional Facility Modifier Low / Median / High Price $66.12 / $79.34 / $100.01	Facility		$66.12	$79.34	$100.01
CareSource Facility/Professional Professional Modifier Low / Median / High Price $120.94 / $126.99 / $167.03	Professional		$120.94	$126.99	$167.03
Cigna Facility/Professional Facility Modifier Low / Median / High Price $359.55 / $420.16 / $644.53	Facility		$359.55	$420.16	$644.53
Cigna Facility/Professional Professional Modifier Low / Median / High Price $126.10 / $269.36 / $599.85	Professional		$126.10	$269.36	$599.85
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $64.63 / $127.10 / $228.78	Facility		$64.63	$127.10	$228.78
Medica Facility/Professional Facility Modifier Low / Median / High Price $66.81 / $143.63 / $2,951.70	Facility		$66.81	$143.63	$2,951.70
Medica Facility/Professional Professional Modifier Low / Median / High Price $132.34 / $297.82 / $1,433.08	Professional		$132.34	$297.82	$1,433.08
Molina Facility/Professional Professional Modifier Low / Median / High Price $78.44 / $134.36 / $312.41	Professional		$78.44	$134.36	$312.41
Prevea360 Facility/Professional Facility Modifier Low / Median / High Price $64.63 / $127.10 / $228.78	Facility		$64.63	$127.10	$228.78
Quartz Facility/Professional Professional Modifier Low / Median / High Price $158.63 / $259.35 / $448.56	Professional		$158.63	$259.35	$448.56
Quartz Facility/Professional Facility Modifier Low / Median / High Price $314.87 / $314.87 / $982.04	Facility		$314.87	$314.87	$982.04
Quartz Facility/Professional Professional Modifier Low / Median / High Price $155.63 / $573.75 / $1,433.08	Professional		$155.63	$573.75	$1,433.08
Security Health Facility/Professional Professional Modifier Low / Median / High Price $234.48 / $403.35 / $790.45	Professional		$234.48	$403.35	$790.45
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 $122.97 / $228.20 / $503.14	Professional		$122.97	$228.20	$503.14