Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $136.94 / $471.05 / $1,894.00	Facility		$136.94	$471.05	$1,894.00
Aetna Facility/Professional Facility Modifier 50 Low / Median / High Price $780.00 / $780.00 / $780.00	Facility	50	$780.00	$780.00	$780.00
Aetna Facility/Professional Professional Modifier Low / Median / High Price $85.76 / $128.69 / $486.05	Professional		$85.76	$128.69	$486.05
Aetna Facility/Professional Professional Modifier 50 Low / Median / High Price $158.16 / $189.41 / $718.99	Professional	50	$158.16	$189.41	$718.99
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 $99.49 / $176.80 / $490.54	Professional		$99.49	$176.80	$490.54
Anthem BCBS Facility/Professional Professional Modifier 50 Low / Median / High Price $149.22 / $270.41 / $762.18	Professional	50	$149.22	$270.41	$762.18
CareSource Facility/Professional Facility Modifier Low / Median / High Price $112.93 / $112.93 / $112.93	Facility		$112.93	$112.93	$112.93
CareSource Facility/Professional Professional Modifier Low / Median / High Price $102.44 / $107.56 / $142.06	Professional		$102.44	$107.56	$142.06
Cigna Facility/Professional Facility Modifier Low / Median / High Price $300.97 / $351.71 / $567.29	Facility		$300.97	$351.71	$567.29
Cigna Facility/Professional Professional Modifier Low / Median / High Price $105.67 / $229.33 / $544.73	Professional		$105.67	$229.33	$544.73
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $101.27 / $160.06 / $376.88	Facility		$101.27	$160.06	$376.88
Medica Facility/Professional Facility Modifier Low / Median / High Price $101.27 / $204.61 / $1,778.00	Facility		$101.27	$204.61	$1,778.00
Medica Facility/Professional Facility Modifier 50 Low / Median / High Price $381.73 / $381.73 / $381.73	Facility	50	$381.73	$381.73	$381.73
Medica Facility/Professional Professional Modifier Low / Median / High Price $115.84 / $329.08 / $1,961.16	Professional		$115.84	$329.08	$1,961.16
Medica Facility/Professional Professional Modifier 50 Low / Median / High Price $191.30 / $496.53 / $1,524.83	Professional	50	$191.30	$496.53	$1,524.83
Molina Facility/Professional Professional Modifier Low / Median / High Price $58.91 / $93.48 / $219.68	Professional		$58.91	$93.48	$219.68
Prevea360 Facility/Professional Facility Modifier Low / Median / High Price $101.27 / $154.99 / $376.88	Facility		$101.27	$154.99	$376.88
Quartz Facility/Professional Professional Modifier Low / Median / High Price $178.10 / $265.83 / $382.70	Professional		$178.10	$265.83	$382.70
Quartz Facility/Professional Facility Modifier Low / Median / High Price $745.85 / $745.85 / $745.85	Facility		$745.85	$745.85	$745.85
Quartz Facility/Professional Professional Modifier Low / Median / High Price $172.20 / $482.04 / $3,149.10	Professional		$172.20	$482.04	$3,149.10
Security Health Facility/Professional Professional Modifier Low / Median / High Price $459.70 / $885.18 / $1,101.43	Professional		$459.70	$885.18	$1,101.43
United Facility/Professional Facility Modifier Low / Median / High Price $785.00 / $1,370.00 / $2,202.90	Facility		$785.00	$1,370.00	$2,202.90
United Facility/Professional Professional Modifier Low / Median / High Price $103.89 / $211.39 / $530.85	Professional		$103.89	$211.39	$530.85