Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $67.18 / $262.89 / $4,733.35	Facility		$67.18	$262.89	$4,733.35
Aetna Facility/Professional Professional Modifier Low / Median / High Price $67.18 / $148.78 / $575.72	Professional		$67.18	$148.78	$575.72
Aetna Facility/Professional Professional Modifier 50 Low / Median / High Price $342.67 / $342.67 / $342.67	Professional	50	$342.67	$342.67	$342.67
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 $90.31 / $154.12 / $330.59	Professional		$90.31	$154.12	$330.59
Anthem BCBS Facility/Professional Professional Modifier 50 Low / Median / High Price $139.81 / $231.18 / $495.88	Professional	50	$139.81	$231.18	$495.88
CareSource Facility/Professional Facility Modifier Low / Median / High Price $68.28 / $81.94 / $103.31	Facility		$68.28	$81.94	$103.31
CareSource Facility/Professional Professional Modifier Low / Median / High Price $140.82 / $147.86 / $193.87	Professional		$140.82	$147.86	$193.87
Cigna Facility/Professional Facility Modifier Low / Median / High Price $427.13 / $499.14 / $765.69	Facility		$427.13	$499.14	$765.69
Cigna Facility/Professional Professional Modifier Low / Median / High Price $125.01 / $298.62 / $709.05	Professional		$125.01	$298.62	$709.05
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $67.18 / $143.57 / $271.39	Facility		$67.18	$143.57	$271.39
Medica Facility/Professional Facility Modifier Low / Median / High Price $69.67 / $163.16 / $2,930.60	Facility		$69.67	$163.16	$2,930.60
Medica Facility/Professional Professional Modifier Low / Median / High Price $143.57 / $303.60 / $1,181.28	Professional		$143.57	$303.60	$1,181.28
Molina Facility/Professional Professional Modifier Low / Median / High Price $77.22 / $143.57 / $315.53	Professional		$77.22	$143.57	$315.53
Prevea360 Facility/Professional Facility Modifier Low / Median / High Price $67.18 / $143.57 / $271.39	Facility		$67.18	$143.57	$271.39
Quartz Facility/Professional Professional Modifier Low / Median / High Price $164.74 / $299.22 / $526.13	Professional		$164.74	$299.22	$526.13
Quartz Facility/Professional Facility Modifier Low / Median / High Price $208.02 / $208.02 / $326.99	Facility		$208.02	$208.02	$326.99
Quartz Facility/Professional Professional Modifier Low / Median / High Price $160.85 / $678.20 / $1,181.28	Professional		$160.85	$678.20	$1,181.28
Security Health Facility/Professional Professional Modifier Low / Median / High Price $240.80 / $416.90 / $934.33	Professional		$240.80	$416.90	$934.33
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 $142.38 / $262.80 / $576.41	Professional		$142.38	$262.80	$576.41