Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $165.20 / $1,144.81 / $4,357.60	Facility		$165.20	$1,144.81	$4,357.60
Aetna Facility/Professional Facility Modifier 50 Low / Median / High Price $1,189.44 / $2,714.59 / $7,044.96	Facility	50	$1,189.44	$2,714.59	$7,044.96
Aetna Facility/Professional Professional Modifier Low / Median / High Price $83.17 / $172.56 / $931.21	Professional		$83.17	$172.56	$931.21
Aetna Facility/Professional Professional Modifier 50 Low / Median / High Price $124.44 / $515.24 / $2,463.75	Professional	50	$124.44	$515.24	$2,463.75
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 $111.80 / $203.68 / $515.61	Professional		$111.80	$203.68	$515.61
Anthem BCBS Facility/Professional Professional Modifier 50 Low / Median / High Price $177.60 / $305.52 / $773.41	Professional	50	$177.60	$305.52	$773.41
CareSource Facility/Professional Facility Modifier Low / Median / High Price $85.45 / $102.54 / $128.18	Facility		$85.45	$102.54	$128.18
CareSource Facility/Professional Professional Modifier Low / Median / High Price $160.22 / $168.24 / $220.01	Professional		$160.22	$168.24	$220.01
Cigna Facility/Professional Facility Modifier Low / Median / High Price $479.40 / $560.21 / $859.38	Facility		$479.40	$560.21	$859.38
Cigna Facility/Professional Professional Modifier Low / Median / High Price $166.77 / $352.17 / $767.59	Professional		$166.77	$352.17	$767.59
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $87.73 / $169.65 / $331.11	Facility		$87.73	$169.65	$331.11
Medica Facility/Professional Facility Modifier Low / Median / High Price $88.71 / $196.27 / $3,034.00	Facility		$88.71	$196.27	$3,034.00
Medica Facility/Professional Facility Modifier 50 Low / Median / High Price $1,087.29 / $2,575.40 / $3,966.40	Facility	50	$1,087.29	$2,575.40	$3,966.40
Medica Facility/Professional Professional Modifier Low / Median / High Price $198.70 / $418.72 / $1,301.58	Professional		$198.70	$418.72	$1,301.58
Medica Facility/Professional Professional Modifier 50 Low / Median / High Price $192.31 / $192.31 / $292.86	Professional	50	$192.31	$192.31	$292.86
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 $87.73 / $169.65 / $331.11	Facility		$87.73	$169.65	$331.11
Quartz Facility/Professional Professional Modifier Low / Median / High Price $208.22 / $378.52 / $598.07	Professional		$208.22	$378.52	$598.07
Quartz Facility/Professional Facility Modifier Low / Median / High Price $413.29 / $413.29 / $982.04	Facility		$413.29	$413.29	$982.04
Quartz Facility/Professional Professional Modifier Low / Median / High Price $203.47 / $759.78 / $3,100.00	Professional		$203.47	$759.78	$3,100.00
Security Health Facility/Professional Professional Modifier Low / Median / High Price $306.25 / $527.32 / $1,046.77	Professional		$306.25	$527.32	$1,046.77
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 $189.84 / $354.84 / $764.21	Professional		$189.84	$354.84	$764.21