Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $58.58 / $428.91 / $7,383.84	Facility		$58.58	$428.91	$7,383.84
Aetna Facility/Professional Professional Modifier Low / Median / High Price $58.58 / $113.89 / $1,092.50	Professional		$58.58	$113.89	$1,092.50
Aetna Facility/Professional Professional Modifier 50 Low / Median / High Price $199.97 / $199.97 / $199.97	Professional	50	$199.97	$199.97	$199.97
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 $78.76 / $143.47 / $315.75	Professional		$78.76	$143.47	$315.75
Anthem BCBS Facility/Professional Professional Modifier 50 Low / Median / High Price $124.96 / $215.20 / $478.97	Professional	50	$124.96	$215.20	$478.97
CareSource Facility/Professional Facility Modifier Low / Median / High Price $60.36 / $72.43 / $91.41	Facility		$60.36	$72.43	$91.41
CareSource Facility/Professional Professional Modifier Low / Median / High Price $105.33 / $110.60 / $145.88	Professional		$105.33	$110.60	$145.88
Cigna Facility/Professional Facility Modifier Low / Median / High Price $310.89 / $363.30 / $557.29	Facility		$310.89	$363.30	$557.29
Cigna Facility/Professional Professional Modifier Low / Median / High Price $116.09 / $245.10 / $519.83	Professional		$116.09	$245.10	$519.83
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $60.68 / $109.90 / $236.36	Facility		$60.68	$109.90	$236.36
Medica Facility/Professional Facility Modifier Low / Median / High Price $62.80 / $135.44 / $3,026.00	Facility		$62.80	$135.44	$3,026.00
Medica Facility/Professional Professional Modifier Low / Median / High Price $95.30 / $227.17 / $1,094.00	Professional		$95.30	$227.17	$1,094.00
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 $59.51 / $109.90 / $236.36	Facility		$59.51	$109.90	$236.36
Quartz Facility/Professional Professional Modifier Low / Median / High Price $144.91 / $226.20 / $391.22	Professional		$144.91	$226.20	$391.22
Quartz Facility/Professional Facility Modifier Low / Median / High Price $133.60 / $133.60 / $287.63	Facility		$133.60	$133.60	$287.63
Quartz Facility/Professional Professional Modifier Low / Median / High Price $135.44 / $497.21 / $1,094.00	Professional		$135.44	$497.21	$1,094.00
Security Health Facility/Professional Professional Modifier Low / Median / High Price $213.22 / $366.99 / $684.94	Professional		$213.22	$366.99	$684.94
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 $96.14 / $189.74 / $395.51	Professional		$96.14	$189.74	$395.51