Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $97.02 / $941.64 / $3,781.63	Facility		$97.02	$941.64	$3,781.63
Aetna Facility/Professional Facility Modifier 50 Low / Median / High Price $933.38 / $2,635.63 / $4,331.46	Facility	50	$933.38	$2,635.63	$4,331.46
Aetna Facility/Professional Professional Modifier Low / Median / High Price $98.88 / $193.34 / $1,157.57	Professional		$98.88	$193.34	$1,157.57
Aetna Facility/Professional Professional Modifier 50 Low / Median / High Price $147.06 / $837.24 / $3,200.25	Professional	50	$147.06	$837.24	$3,200.25
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 $130.43 / $237.61 / $603.40	Professional		$130.43	$237.61	$603.40
Anthem BCBS Facility/Professional Professional Modifier 50 Low / Median / High Price $206.41 / $356.41 / $905.10	Professional	50	$206.41	$356.41	$905.10
CareSource Facility/Professional Facility Modifier Low / Median / High Price $99.03 / $118.84 / $148.55	Facility		$99.03	$118.84	$148.55
CareSource Facility/Professional Professional Modifier Low / Median / High Price $173.97 / $182.67 / $239.18	Professional		$173.97	$182.67	$239.18
Cigna Facility/Professional Facility Modifier Low / Median / High Price $518.14 / $605.49 / $928.84	Facility		$518.14	$605.49	$928.84
Cigna Facility/Professional Professional Modifier Low / Median / High Price $190.12 / $409.38 / $862.38	Professional		$190.12	$409.38	$862.38
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $101.34 / $183.25 / $364.71	Facility		$101.34	$183.25	$364.71
Medica Facility/Professional Facility Modifier Low / Median / High Price $102.70 / $218.05 / $3,034.00	Facility		$102.70	$218.05	$3,034.00
Medica Facility/Professional Facility Modifier 50 Low / Median / High Price $967.93 / $2,640.60 / $2,821.41	Facility	50	$967.93	$2,640.60	$2,821.41
Medica Facility/Professional Professional Modifier Low / Median / High Price $222.35 / $484.34 / $1,426.65	Professional		$222.35	$484.34	$1,426.65
Medica Facility/Professional Professional Modifier 50 Low / Median / High Price $336.13 / $336.13 / $336.13	Professional	50	$336.13	$336.13	$336.13
Molina Facility/Professional Professional Modifier Low / Median / High Price $115.39 / $202.48 / $471.74	Professional		$115.39	$202.48	$471.74
Prevea360 Facility/Professional Facility Modifier Low / Median / High Price $101.34 / $183.25 / $364.71	Facility		$101.34	$183.25	$364.71
Quartz Facility/Professional Professional Modifier Low / Median / High Price $241.01 / $414.72 / $647.54	Professional		$241.01	$414.72	$647.54
Quartz Facility/Professional Facility Modifier Low / Median / High Price $478.34 / $478.34 / $982.04	Facility		$478.34	$478.34	$982.04
Quartz Facility/Professional Professional Modifier Low / Median / High Price $236.53 / $824.85 / $3,500.00	Professional		$236.53	$824.85	$3,500.00
Security Health Facility/Professional Professional Modifier Low / Median / High Price $355.95 / $613.03 / $1,136.39	Professional		$355.95	$613.03	$1,136.39
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 $209.18 / $384.61 / $870.48	Professional		$209.18	$384.61	$870.48