Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $75.59 / $214.73 / $1,894.00	Facility		$75.59	$214.73	$1,894.00
Aetna Facility/Professional Professional Modifier Low / Median / High Price $75.59 / $214.73 / $417.97	Professional		$75.59	$214.73	$417.97
Aetna Facility/Professional Professional Modifier 50 Low / Median / High Price $220.42 / $298.08 / $298.85	Professional	50	$220.42	$298.08	$298.85
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 $106.83 / $204.60 / $466.37	Professional		$106.83	$204.60	$466.37
Anthem BCBS Facility/Professional Professional Modifier 50 Low / Median / High Price $179.35 / $306.89 / $699.55	Professional	50	$179.35	$306.89	$699.55
Cigna Facility/Professional Facility Modifier Low / Median / High Price $619.07 / $723.43 / $1,109.76	Facility		$619.07	$723.43	$1,109.76
Cigna Facility/Professional Professional Modifier Low / Median / High Price $150.06 / $360.71 / $1,021.64	Professional		$150.06	$360.71	$1,021.64
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $75.59 / $195.49 / $386.51	Facility		$75.59	$195.49	$386.51
Medica Facility/Professional Facility Modifier Low / Median / High Price $79.68 / $248.52 / $3,593.00	Facility		$79.68	$248.52	$3,593.00
Medica Facility/Professional Professional Modifier Low / Median / High Price $234.93 / $425.48 / $1,578.26	Professional		$234.93	$425.48	$1,578.26
Molina Facility/Professional Professional Modifier Low / Median / High Price $132.62 / $222.38 / $551.40	Professional		$132.62	$222.38	$551.40
Prevea360 Facility/Professional Facility Modifier Low / Median / High Price $75.59 / $195.49 / $346.04	Facility		$75.59	$195.49	$346.04
Quartz Facility/Professional Professional Modifier Low / Median / High Price $180.28 / $341.18 / $726.97	Professional		$180.28	$341.18	$726.97
Quartz Facility/Professional Facility Modifier Low / Median / High Price $372.39 / $372.39 / $763.85	Facility		$372.39	$372.39	$763.85
Quartz Facility/Professional Professional Modifier Low / Median / High Price $191.37 / $611.91 / $1,886.00	Professional		$191.37	$611.91	$1,886.00
Security Health Facility/Professional Professional Modifier Low / Median / High Price $475.33 / $749.42 / $1,346.26	Professional		$475.33	$749.42	$1,346.26
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 $228.20 / $410.46 / $920.52	Professional		$228.20	$410.46	$920.52