Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $31.21 / $103.84 / $1,894.00	Facility		$31.21	$103.84	$1,894.00
Aetna Facility/Professional Professional Modifier Low / Median / High Price $32.10 / $53.04 / $425.70	Professional		$32.10	$53.04	$425.70
Aetna Facility/Professional Professional Modifier 50 Low / Median / High Price $64.88 / $171.00 / $286.37	Professional	50	$64.88	$171.00	$286.37
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 $41.96 / $76.44 / $192.69	Professional		$41.96	$76.44	$192.69
Anthem BCBS Facility/Professional Professional Modifier 50 Low / Median / High Price $65.34 / $114.66 / $290.87	Professional	50	$65.34	$114.66	$290.87
CareSource Facility/Professional Facility Modifier Low / Median / High Price $31.53 / $37.84 / $47.57	Facility		$31.53	$37.84	$47.57
CareSource Facility/Professional Professional Modifier Low / Median / High Price $45.62 / $47.90 / $63.43	Professional		$45.62	$47.90	$63.43
Cigna Facility/Professional Facility Modifier Low / Median / High Price $133.37 / $155.85 / $239.08	Facility		$133.37	$155.85	$239.08
Cigna Facility/Professional Professional Modifier Low / Median / High Price $54.37 / $122.10 / $223.99	Professional		$54.37	$122.10	$223.99
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $31.94 / $48.80 / $94.10	Facility		$31.94	$48.80	$94.10
Medica Facility/Professional Facility Modifier Low / Median / High Price $32.61 / $61.76 / $1,449.00	Facility		$32.61	$61.76	$1,449.00
Medica Facility/Professional Professional Modifier Low / Median / High Price $55.97 / $103.57 / $376.88	Professional		$55.97	$103.57	$376.88
Medica Facility/Professional Professional Modifier 50 Low / Median / High Price $200.00 / $200.00 / $451.44	Professional	50	$200.00	$200.00	$451.44
Molina Facility/Professional Professional Modifier Low / Median / High Price $41.03 / $70.00 / $150.12	Professional		$41.03	$70.00	$150.12
Prevea360 Facility/Professional Facility Modifier Low / Median / High Price $31.94 / $48.80 / $94.10	Facility		$31.94	$48.80	$94.10
Quartz Facility/Professional Professional Modifier Low / Median / High Price $75.50 / $112.42 / $167.51	Professional		$75.50	$112.42	$167.51
Quartz Facility/Professional Facility Modifier Low / Median / High Price $45.86 / $45.86 / $149.85	Facility		$45.86	$45.86	$149.85
Quartz Facility/Professional Professional Modifier Low / Median / High Price $76.28 / $214.25 / $376.88	Professional		$76.28	$214.25	$376.88
Security Health Facility/Professional Professional Modifier Low / Median / High Price $112.69 / $194.43 / $295.14	Professional		$112.69	$194.43	$295.14
United Facility/Professional Facility Modifier Low / Median / High Price $1,008.00 / $1,370.00 / $2,202.90	Facility		$1,008.00	$1,370.00	$2,202.90
United Facility/Professional Professional Modifier Low / Median / High Price $52.44 / $94.58 / $212.81	Professional		$52.44	$94.58	$212.81