Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $51.35 / $177.21 / $1,894.00	Facility		$51.35	$177.21	$1,894.00
Aetna Facility/Professional Professional Modifier Low / Median / High Price $53.45 / $87.12 / $492.72	Professional		$53.45	$87.12	$492.72
Aetna Facility/Professional Professional Modifier 50 Low / Median / High Price $326.91 / $326.91 / $326.91	Professional	50	$326.91	$326.91	$326.91
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 $69.02 / $125.75 / $347.08	Professional		$69.02	$125.75	$347.08
Anthem BCBS Facility/Professional Professional Modifier 50 Low / Median / High Price $107.10 / $188.62 / $520.62	Professional	50	$107.10	$188.62	$520.62
Cigna Facility/Professional Facility Modifier Low / Median / High Price $228.88 / $267.47 / $410.31	Facility		$228.88	$267.47	$410.31
Cigna Facility/Professional Professional Modifier Low / Median / High Price $96.10 / $213.80 / $383.81	Professional		$96.10	$213.80	$383.81
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $51.35 / $87.12 / $175.44	Facility		$51.35	$87.12	$175.44
Medica Facility/Professional Facility Modifier Low / Median / High Price $54.52 / $109.87 / $2,951.70	Facility		$54.52	$109.87	$2,951.70
Medica Facility/Professional Professional Modifier Low / Median / High Price $114.14 / $248.00 / $1,157.00	Professional		$114.14	$248.00	$1,157.00
Molina Facility/Professional Professional Modifier Low / Median / High Price $41.03 / $98.74 / $184.69	Professional		$41.03	$98.74	$184.69
Prevea360 Facility/Professional Facility Modifier Low / Median / High Price $51.35 / $87.12 / $175.44	Facility		$51.35	$87.12	$175.44
Quartz Facility/Professional Professional Modifier Low / Median / High Price $126.61 / $196.26 / $290.04	Professional		$126.61	$196.26	$290.04
Quartz Facility/Professional Facility Modifier Low / Median / High Price $89.73 / $89.73 / $254.78	Facility		$89.73	$89.73	$254.78
Quartz Facility/Professional Professional Modifier Low / Median / High Price $127.02 / $330.40 / $1,157.00	Professional		$127.02	$330.40	$1,157.00
Security Health Facility/Professional Professional Modifier Low / Median / High Price $232.11 / $320.10 / $517.71	Professional		$232.11	$320.10	$517.71
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 $96.97 / $209.37 / $411.73	Professional		$96.97	$209.37	$411.73