Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $0.96 / $636.17 / $2,066.69	Facility		$0.96	$636.17	$2,066.69
Aetna Facility/Professional Facility Modifier 53 Low / Median / High Price $9.50 / $20.98 / $81.25	Facility	53	$9.50	$20.98	$81.25
Aetna Facility/Professional Professional Modifier Low / Median / High Price $48.46 / $136.27 / $598.00	Professional		$48.46	$136.27	$598.00
Aetna Facility/Professional Professional Modifier 50 Low / Median / High Price $69.93 / $122.49 / $204.41	Professional	50	$69.93	$122.49	$204.41
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $1,139.00 / $1,183.00 / $1,530.00	Facility		$1,139.00	$1,183.00	$1,530.00
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $63.86 / $116.33 / $287.64	Professional		$63.86	$116.33	$287.64
Anthem BCBS Facility/Professional Professional Modifier 50 Low / Median / High Price $100.81 / $174.49 / $442.41	Professional	50	$100.81	$174.49	$442.41
CareSource Facility/Professional Facility Modifier Low / Median / High Price $47.69 / $57.23 / $71.69	Facility		$47.69	$57.23	$71.69
CareSource Facility/Professional Professional Modifier Low / Median / High Price $99.21 / $104.17 / $135.97	Professional		$99.21	$104.17	$135.97
Cigna Facility/Professional Facility Modifier Low / Median / High Price $300.07 / $350.66 / $537.91	Facility		$300.07	$350.66	$537.91
Cigna Facility/Professional Professional Modifier Low / Median / High Price $93.03 / $210.72 / $497.53	Professional		$93.03	$210.72	$497.53
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $47.50 / $104.40 / $190.00	Facility		$47.50	$104.40	$190.00
Medica Facility/Professional Facility Modifier Low / Median / High Price $49.94 / $116.16 / $1,411.33	Facility		$49.94	$116.16	$1,411.33
Medica Facility/Professional Professional Modifier Low / Median / High Price $118.42 / $286.37 / $2,512.54	Professional		$118.42	$286.37	$2,512.54
Molina Facility/Professional Professional Modifier Low / Median / High Price $58.91 / $101.31 / $235.87	Professional		$58.91	$101.31	$235.87
Prevea360 Facility/Professional Facility Modifier Low / Median / High Price $47.50 / $104.40 / $190.00	Facility		$47.50	$104.40	$190.00
Quartz Facility/Professional Professional Modifier Low / Median / High Price $115.17 / $214.00 / $368.74	Professional		$115.17	$214.00	$368.74
Quartz Facility/Professional Facility Modifier Low / Median / High Price $354.52 / $354.52 / $354.52	Facility		$354.52	$354.52	$354.52
Quartz Facility/Professional Facility Modifier 53 Low / Median / High Price $48.61 / $48.61 / $48.61	Facility	53	$48.61	$48.61	$48.61
Quartz Facility/Professional Professional Modifier Low / Median / High Price $120.03 / $475.88 / $2,512.54	Professional		$120.03	$475.88	$2,512.54
Security Health Facility/Professional Professional Modifier Low / Median / High Price $170.83 / $298.10 / $655.58	Professional		$170.83	$298.10	$655.58
United Facility/Professional Facility Modifier Low / Median / High Price $1,034.00 / $1,423.00 / $2,202.90	Facility		$1,034.00	$1,423.00	$2,202.90
United Facility/Professional Professional Modifier Low / Median / High Price $110.80 / $218.33 / $458.35	Professional		$110.80	$218.33	$458.35