Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $47.19 / $947.00 / $4,757.76	Facility		$47.19	$947.00	$4,757.76
Aetna Facility/Professional Facility Modifier 50 Low / Median / High Price $1.76 / $4,572.72 / $6,585.90	Facility	50	$1.76	$4,572.72	$6,585.90
Aetna Facility/Professional Professional Modifier Low / Median / High Price $48.53 / $114.72 / $750.60	Professional		$48.53	$114.72	$750.60
Aetna Facility/Professional Professional Modifier 50 Low / Median / High Price $72.23 / $217.41 / $1,395.00	Professional	50	$72.23	$217.41	$1,395.00
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 $63.43 / $115.56 / $286.39	Professional		$63.43	$115.56	$286.39
Anthem BCBS Facility/Professional Professional Modifier 50 Low / Median / High Price $98.88 / $173.34 / $439.45	Professional	50	$98.88	$173.34	$439.45
CareSource Facility/Professional Facility Modifier Low / Median / High Price $48.06 / $57.67 / $72.56	Facility		$48.06	$57.67	$72.56
CareSource Facility/Professional Professional Modifier Low / Median / High Price $82.23 / $86.34 / $113.76	Professional		$82.23	$86.34	$113.76
Cigna Facility/Professional Facility Modifier Low / Median / High Price $243.30 / $284.32 / $436.15	Facility		$243.30	$284.32	$436.15
Cigna Facility/Professional Professional Modifier Low / Median / High Price $89.61 / $196.45 / $406.06	Professional		$89.61	$196.45	$406.06
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $49.09 / $87.11 / $169.73	Facility		$49.09	$87.11	$169.73
Medica Facility/Professional Facility Modifier Low / Median / High Price $49.64 / $104.62 / $1,449.00	Facility		$49.64	$104.62	$1,449.00
Medica Facility/Professional Facility Modifier 50 Low / Median / High Price $450.00 / $1,235.25 / $1,670.55	Facility	50	$450.00	$1,235.25	$1,670.55
Medica Facility/Professional Professional Modifier Low / Median / High Price $101.52 / $189.33 / $667.00	Professional		$101.52	$189.33	$667.00
Medica Facility/Professional Professional Modifier 50 Low / Median / High Price $108.36 / $108.36 / $163.52	Professional	50	$108.36	$108.36	$163.52
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 $49.09 / $87.11 / $169.73	Facility		$49.09	$87.11	$169.73
Quartz Facility/Professional Professional Modifier Low / Median / High Price $115.92 / $198.37 / $305.77	Professional		$115.92	$198.37	$305.77
Quartz Facility/Professional Facility Modifier Low / Median / High Price $230.12 / $230.12 / $230.12	Facility		$230.12	$230.12	$230.12
Quartz Facility/Professional Professional Modifier Low / Median / High Price $115.59 / $388.40 / $1,800.00	Professional		$115.59	$388.40	$1,800.00
Security Health Facility/Professional Professional Modifier Low / Median / High Price $170.50 / $294.20 / $535.14	Professional		$170.50	$294.20	$535.14
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 $97.23 / $175.76 / $391.62	Professional		$97.23	$175.76	$391.62