Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $54.60 / $1,319.82 / $3,667.44	Facility		$54.60	$1,319.82	$3,667.44
Aetna Facility/Professional Facility Modifier 50 Low / Median / High Price $764.80 / $989.86 / $3,505.20	Facility	50	$764.80	$989.86	$3,505.20
Aetna Facility/Professional Professional Modifier Low / Median / High Price $55.75 / $100.33 / $522.53	Professional		$55.75	$100.33	$522.53
Aetna Facility/Professional Professional Modifier 50 Low / Median / High Price $87.28 / $452.01 / $1,868.37	Professional	50	$87.28	$452.01	$1,868.37
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 $73.40 / $133.72 / $333.09	Professional		$73.40	$133.72	$333.09
Anthem BCBS Facility/Professional Professional Modifier 50 Low / Median / High Price $115.18 / $200.58 / $510.99	Professional	50	$115.18	$200.58	$510.99
CareSource Facility/Professional Facility Modifier Low / Median / High Price $56.30 / $67.56 / $85.19	Facility		$56.30	$67.56	$85.19
CareSource Facility/Professional Professional Modifier Low / Median / High Price $88.47 / $92.89 / $123.03	Professional		$88.47	$92.89	$123.03
Cigna Facility/Professional Facility Modifier Low / Median / High Price $259.52 / $303.27 / $465.23	Facility		$259.52	$303.27	$465.23
Cigna Facility/Professional Professional Modifier Low / Median / High Price $98.26 / $228.66 / $433.69	Professional		$98.26	$228.66	$433.69
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $57.41 / $93.54 / $183.22	Facility		$57.41	$93.54	$183.22
Medica Facility/Professional Facility Modifier Low / Median / High Price $57.62 / $118.31 / $1,455.00	Facility		$57.62	$118.31	$1,455.00
Medica Facility/Professional Facility Modifier 50 Low / Median / High Price $969.17 / $969.17 / $1,213.82	Facility	50	$969.17	$969.17	$1,213.82
Medica Facility/Professional Professional Modifier Low / Median / High Price $109.21 / $213.26 / $715.99	Professional		$109.21	$213.26	$715.99
Medica Facility/Professional Professional Modifier 50 Low / Median / High Price $188.05 / $188.05 / $188.05	Professional	50	$188.05	$188.05	$188.05
Molina Facility/Professional Professional Modifier Low / Median / High Price $58.91 / $101.24 / $235.87	Professional		$58.91	$101.24	$235.87
Prevea360 Facility/Professional Facility Modifier Low / Median / High Price $57.41 / $93.54 / $183.22	Facility		$57.41	$93.54	$183.22
Quartz Facility/Professional Professional Modifier Low / Median / High Price $131.25 / $213.68 / $329.39	Professional		$131.25	$213.68	$329.39
Quartz Facility/Professional Facility Modifier Low / Median / High Price $269.47 / $269.47 / $269.47	Facility		$269.47	$269.47	$269.47
Quartz Facility/Professional Professional Modifier Low / Median / High Price $133.99 / $414.81 / $2,750.00	Professional		$133.99	$414.81	$2,750.00
Security Health Facility/Professional Professional Modifier Low / Median / High Price $198.64 / $342.41 / $571.50	Professional		$198.64	$342.41	$571.50
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 $106.98 / $185.60 / $420.38	Professional		$106.98	$185.60	$420.38