Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $61.81 / $961.74 / $3,964.80	Facility		$61.81	$961.74	$3,964.80
Aetna Facility/Professional Professional Modifier Low / Median / High Price $62.97 / $242.90 / $827.27	Professional		$62.97	$242.90	$827.27
Aetna Facility/Professional Professional Modifier 50 Low / Median / High Price $93.56 / $287.30 / $2,973.60	Professional	50	$93.56	$287.30	$2,973.60
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 $86.78 / $183.80 / $377.80	Professional		$86.78	$183.80	$377.80
Anthem BCBS Facility/Professional Professional Modifier 50 Low / Median / High Price $146.63 / $275.70 / $576.62	Professional	50	$146.63	$275.70	$576.62
CareSource Facility/Professional Facility Modifier Low / Median / High Price $63.25 / $75.90 / $95.46	Facility		$63.25	$75.90	$95.46
CareSource Facility/Professional Professional Modifier Low / Median / High Price $223.98 / $235.18 / $303.83	Professional		$223.98	$235.18	$303.83
Cigna Facility/Professional Facility Modifier Low / Median / High Price $697.47 / $815.05 / $1,250.30	Facility		$697.47	$815.05	$1,250.30
Cigna Facility/Professional Professional Modifier Low / Median / High Price $121.88 / $294.38 / $1,145.70	Professional		$121.88	$294.38	$1,145.70
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $64.44 / $205.86 / $389.45	Facility		$64.44	$205.86	$389.45
Medica Facility/Professional Facility Modifier Low / Median / High Price $69.30 / $265.19 / $1,642.00	Facility		$69.30	$265.19	$1,642.00
Medica Facility/Professional Professional Modifier Low / Median / High Price $219.12 / $399.89 / $1,408.83	Professional		$219.12	$399.89	$1,408.83
Molina Facility/Professional Professional Modifier Low / Median / High Price $130.72 / $235.96 / $554.52	Professional		$130.72	$235.96	$554.52
Prevea360 Facility/Professional Facility Modifier Low / Median / High Price $64.44 / $198.73 / $389.45	Facility		$64.44	$198.73	$389.45
Quartz Facility/Professional Professional Modifier Low / Median / High Price $152.54 / $300.66 / $825.19	Professional		$152.54	$300.66	$825.19
Quartz Facility/Professional Facility Modifier Low / Median / High Price $457.41 / $457.41 / $457.41	Facility		$457.41	$457.41	$457.41
Quartz Facility/Professional Professional Modifier Low / Median / High Price $151.66 / $607.82 / $2,060.00	Professional		$151.66	$607.82	$2,060.00
Security Health Facility/Professional Professional Modifier Low / Median / High Price $313.10 / $387.91 / $1,509.68	Professional		$313.10	$387.91	$1,509.68
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 $216.04 / $379.81 / $827.18	Professional		$216.04	$379.81	$827.18