Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $94.30 / $213.03 / $1,894.00	Facility		$94.30	$213.03	$1,894.00
Aetna Facility/Professional Facility Modifier 50 Low / Median / High Price $561.67 / $561.67 / $1,432.60	Facility	50	$561.67	$561.67	$1,432.60
Aetna Facility/Professional Professional Modifier Low / Median / High Price $94.50 / $129.78 / $553.03	Professional		$94.50	$129.78	$553.03
Aetna Facility/Professional Professional Modifier 50 Low / Median / High Price $168.66 / $783.00 / $1,593.75	Professional	50	$168.66	$783.00	$1,593.75
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 $118.70 / $228.79 / $568.98	Professional		$118.70	$228.79	$568.98
Anthem BCBS Facility/Professional Professional Modifier 50 Low / Median / High Price $183.00 / $346.42 / $877.55	Professional	50	$183.00	$346.42	$877.55
CareSource Facility/Professional Facility Modifier Low / Median / High Price $104.58 / $125.50 / $161.40	Facility		$104.58	$125.50	$161.40
CareSource Facility/Professional Professional Modifier Low / Median / High Price $121.30 / $127.54 / $175.77	Professional		$121.30	$127.54	$175.77
Cigna Facility/Professional Facility Modifier Low / Median / High Price $349.63 / $408.58 / $626.77	Facility		$349.63	$408.58	$626.77
Cigna Facility/Professional Professional Modifier Low / Median / High Price $164.79 / $358.48 / $587.29	Professional		$164.79	$358.48	$587.29
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $100.26 / $144.28 / $266.87	Facility		$100.26	$144.28	$266.87
Medica Facility/Professional Facility Modifier Low / Median / High Price $110.33 / $180.95 / $1,449.00	Facility		$110.33	$180.95	$1,449.00
Medica Facility/Professional Professional Modifier Low / Median / High Price $144.75 / $255.40 / $947.37	Professional		$144.75	$255.40	$947.37
Molina Facility/Professional Professional Modifier Low / Median / High Price $68.89 / $167.11 / $352.93	Professional		$68.89	$167.11	$352.93
Prevea360 Facility/Professional Facility Modifier Low / Median / High Price $100.26 / $143.90 / $266.87	Facility		$100.26	$143.90	$266.87
Quartz Facility/Professional Professional Modifier Low / Median / High Price $243.64 / $330.51 / $471.04	Professional		$243.64	$330.51	$471.04
Quartz Facility/Professional Facility Modifier Low / Median / High Price $142.22 / $142.22 / $504.08	Facility		$142.22	$142.22	$504.08
Quartz Facility/Professional Professional Modifier Low / Median / High Price $221.47 / $561.74 / $1,000.00	Professional		$221.47	$561.74	$1,000.00
Security Health Facility/Professional Professional Modifier Low / Median / High Price $375.46 / $600.11 / $773.87	Professional		$375.46	$600.11	$773.87
United Facility/Professional Facility Modifier Low / Median / High Price $1,008.00 / $1,370.00 / $2,202.90	Facility		$1,008.00	$1,370.00	$2,202.90
United Facility/Professional Professional Modifier Low / Median / High Price $139.41 / $234.36 / $538.13	Professional		$139.41	$234.36	$538.13