Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $76.29 / $1,999.78 / $3,964.80	Facility		$76.29	$1,999.78	$3,964.80
Aetna Facility/Professional Facility Modifier 50 Low / Median / High Price $3,369.16 / $3,503.48 / $5,871.60	Facility	50	$3,369.16	$3,503.48	$5,871.60
Aetna Facility/Professional Professional Modifier Low / Median / High Price $54.85 / $219.75 / $1,269.00	Professional		$54.85	$219.75	$1,269.00
Aetna Facility/Professional Professional Modifier 50 Low / Median / High Price $81.45 / $258.81 / $975.38	Professional	50	$81.45	$258.81	$975.38
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 $76.20 / $167.09 / $360.97	Professional		$76.20	$167.09	$360.97
Anthem BCBS Facility/Professional Professional Modifier 50 Low / Median / High Price $129.30 / $250.63 / $548.98	Professional	50	$129.30	$250.63	$548.98
CareSource Facility/Professional Facility Modifier Low / Median / High Price $55.68 / $66.81 / $84.12	Facility		$55.68	$66.81	$84.12
CareSource Facility/Professional Professional Modifier Low / Median / High Price $209.99 / $220.49 / $284.66	Professional		$209.99	$220.49	$284.66
Cigna Facility/Professional Facility Modifier Low / Median / High Price $655.11 / $765.55 / $1,174.38	Facility		$655.11	$765.55	$1,174.38
Cigna Facility/Professional Professional Modifier Low / Median / High Price $105.98 / $271.04 / $1,076.10	Professional		$105.98	$271.04	$1,076.10
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $56.81 / $187.14 / $367.09	Facility		$56.81	$187.14	$367.09
Medica Facility/Professional Facility Modifier Low / Median / High Price $57.03 / $247.77 / $1,695.60	Facility		$57.03	$247.77	$1,695.60
Medica Facility/Professional Facility Modifier 50 Low / Median / High Price $774.75 / $1,044.49 / $3,661.80	Facility	50	$774.75	$1,044.49	$3,661.80
Medica Facility/Professional Professional Modifier Low / Median / High Price $196.72 / $364.50 / $1,284.15	Professional		$196.72	$364.50	$1,284.15
Medica Facility/Professional Professional Modifier 50 Low / Median / High Price $816.27 / $816.27 / $816.27	Professional	50	$816.27	$816.27	$816.27
Molina Facility/Professional Professional Modifier Low / Median / High Price $130.72 / $231.11 / $546.26	Professional		$130.72	$231.11	$546.26
Prevea360 Facility/Professional Facility Modifier Low / Median / High Price $56.81 / $181.20 / $367.09	Facility		$56.81	$181.20	$367.09
Quartz Facility/Professional Professional Modifier Low / Median / High Price $134.24 / $262.99 / $757.26	Professional		$134.24	$262.99	$757.26
Quartz Facility/Professional Facility Modifier Low / Median / High Price $429.16 / $429.16 / $429.16	Facility		$429.16	$429.16	$429.16
Quartz Facility/Professional Professional Modifier Low / Median / High Price $133.50 / $570.91 / $1,779.12	Professional		$133.50	$570.91	$1,779.12
Security Health Facility/Professional Professional Modifier Low / Median / High Price $273.72 / $339.70 / $1,418.04	Professional		$273.72	$339.70	$1,418.04
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 $195.96 / $364.50 / $753.97	Professional		$195.96	$364.50	$753.97