Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $92.77 / $210.06 / $1,894.00	Facility		$92.77	$210.06	$1,894.00
Aetna Facility/Professional Professional Modifier Low / Median / High Price $92.77 / $131.53 / $396.78	Professional		$92.77	$131.53	$396.78
Aetna Facility/Professional Professional Modifier 50 Low / Median / High Price $2,692.44 / $2,692.44 / $2,692.44	Professional	50	$2,692.44	$2,692.44	$2,692.44
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 $112.50 / $210.75 / $543.96	Professional		$112.50	$210.75	$543.96
Anthem BCBS Facility/Professional Professional Modifier 50 Low / Median / High Price $168.75 / $323.27 / $815.94	Professional	50	$168.75	$323.27	$815.94
Cigna Facility/Professional Facility Modifier Low / Median / High Price $376.67 / $440.17 / $675.23	Facility		$376.67	$440.17	$675.23
Cigna Facility/Professional Professional Modifier Low / Median / High Price $157.34 / $356.09 / $627.85	Professional		$157.34	$356.09	$627.85
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $92.77 / $139.16 / $231.72	Facility		$92.77	$139.16	$231.72
Medica Facility/Professional Facility Modifier Low / Median / High Price $92.77 / $152.47 / $1,449.00	Facility		$92.77	$152.47	$1,449.00
Medica Facility/Professional Professional Modifier Low / Median / High Price $126.50 / $266.16 / $1,058.16	Professional		$126.50	$266.16	$1,058.16
Molina Facility/Professional Professional Modifier Low / Median / High Price $77.22 / $134.27 / $315.53	Professional		$77.22	$134.27	$315.53
Prevea360 Facility/Professional Facility Modifier Low / Median / High Price $92.77 / $139.16 / $231.72	Facility		$92.77	$139.16	$231.72
Quartz Facility/Professional Professional Modifier Low / Median / High Price $237.06 / $338.60 / $474.91	Professional		$237.06	$338.60	$474.91
Quartz Facility/Professional Facility Modifier Low / Median / High Price $175.45 / $175.45 / $485.92	Facility		$175.45	$175.45	$485.92
Quartz Facility/Professional Professional Modifier Low / Median / High Price $227.77 / $600.53 / $1,058.16	Professional		$227.77	$600.53	$1,058.16
Security Health Facility/Professional Professional Modifier Low / Median / High Price $314.31 / $590.35 / $827.32	Professional		$314.31	$590.35	$827.32
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 $129.88 / $220.62 / $526.55	Professional		$129.88	$220.62	$526.55