Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $182.69 / $253.94 / $14,482.00	Facility		$182.69	$253.94	$14,482.00
Aetna Facility/Professional Professional Modifier Low / Median / High Price $114.92 / $180.64 / $429.28	Professional		$114.92	$180.64	$429.28
Aetna Facility/Professional Professional Modifier 50 Low / Median / High Price $172.38 / $172.38 / $172.38	Professional	50	$172.38	$172.38	$172.38
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 $119.90 / $235.87 / $617.40	Professional		$119.90	$235.87	$617.40
Anthem BCBS Facility/Professional Professional Modifier 50 Low / Median / High Price $191.95 / $360.75 / $926.11	Professional	50	$191.95	$360.75	$926.11
Cigna Facility/Professional Facility Modifier Low / Median / High Price $361.35 / $422.27 / $681.10	Facility		$361.35	$422.27	$681.10
Cigna Facility/Professional Professional Modifier Low / Median / High Price $136.06 / $288.68 / $596.03	Professional		$136.06	$288.68	$596.03
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $112.86 / $165.73 / $251.84	Facility		$112.86	$165.73	$251.84
Medica Facility/Professional Facility Modifier Low / Median / High Price $116.59 / $219.23 / $1,789.00	Facility		$116.59	$219.23	$1,789.00
Medica Facility/Professional Professional Modifier Low / Median / High Price $130.53 / $285.73 / $1,546.10	Professional		$130.53	$285.73	$1,546.10
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 $112.86 / $165.73 / $252.37	Facility		$112.86	$165.73	$252.37
Quartz Facility/Professional Professional Modifier Low / Median / High Price $237.90 / $316.31 / $455.38	Professional		$237.90	$316.31	$455.38
Quartz Facility/Professional Facility Modifier Low / Median / High Price $858.60 / $858.60 / $858.60	Facility		$858.60	$858.60	$858.60
Quartz Facility/Professional Professional Modifier Low / Median / High Price $212.39 / $588.10 / $1,546.10	Professional		$212.39	$588.10	$1,546.10
Security Health Facility/Professional Professional Modifier Low / Median / High Price $390.80 / $1,189.65 / $1,317.37	Professional		$390.80	$1,189.65	$1,317.37
United Facility/Professional Facility Modifier Low / Median / High Price $1,008.00 / $1,495.00 / $2,202.90	Facility		$1,008.00	$1,495.00	$2,202.90
United Facility/Professional Professional Modifier Low / Median / High Price $130.53 / $250.02 / $566.48	Professional		$130.53	$250.02	$566.48