Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $57.31 / $132.50 / $14,482.00	Facility		$57.31	$132.50	$14,482.00
Aetna Facility/Professional Facility Modifier 52 Low / Median / High Price $28.66 / $28.66 / $118.07	Facility	52	$28.66	$28.66	$118.07
Aetna Facility/Professional Professional Modifier Low / Median / High Price $57.31 / $62.77 / $280.77	Professional		$57.31	$62.77	$280.77
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 $77.04 / $140.35 / $380.82	Professional		$77.04	$140.35	$380.82
Cigna Facility/Professional Facility Modifier Low / Median / High Price $162.19 / $189.55 / $290.77	Facility		$162.19	$189.55	$290.77
Cigna Facility/Professional Professional Modifier Low / Median / High Price $104.45 / $244.73 / $278.10	Professional		$104.45	$244.73	$278.10
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $57.31 / $87.68 / $172.96	Facility		$57.31	$87.68	$172.96
Medica Facility/Professional Facility Modifier Low / Median / High Price $60.06 / $132.50 / $3,995.00	Facility		$60.06	$132.50	$3,995.00
Medica Facility/Professional Professional Modifier Low / Median / High Price $82.53 / $183.75 / $1,398.72	Professional		$82.53	$183.75	$1,398.72
Molina Facility/Professional Professional Modifier Low / Median / High Price $40.93 / $72.32 / $156.20	Professional		$40.93	$72.32	$156.20
Prevea360 Facility/Professional Facility Modifier Low / Median / High Price $57.31 / $85.97 / $172.96	Facility		$57.31	$85.97	$172.96
Quartz Facility/Professional Professional Modifier Low / Median / High Price $126.75 / $154.44 / $261.86	Professional		$126.75	$154.44	$261.86
Quartz Facility/Professional Facility Modifier Low / Median / High Price $982.04 / $982.04 / $2,710.90	Facility		$982.04	$982.04	$2,710.90
Quartz Facility/Professional Facility Modifier 52 Low / Median / High Price $2,055.60 / $2,055.60 / $2,055.60	Facility	52	$2,055.60	$2,055.60	$2,055.60
Quartz Facility/Professional Professional Modifier Low / Median / High Price $122.95 / $466.35 / $1,398.72	Professional		$122.95	$466.35	$1,398.72
Security Health Facility/Professional Professional Modifier Low / Median / High Price $198.95 / $366.42 / $366.42	Professional		$198.95	$366.42	$366.42
United Facility/Professional Facility Modifier Low / Median / High Price $1,957.00 / $3,068.00 / $4,295.00	Facility		$1,957.00	$3,068.00	$4,295.00
United Facility/Professional Professional Modifier Low / Median / High Price $72.91 / $155.04 / $317.89	Professional		$72.91	$155.04	$317.89