Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $32.29 / $213.43 / $352.38	Facility		$32.29	$213.43	$352.38
Aetna Facility/Professional Professional Modifier Low / Median / High Price $12.49 / $38.61 / $97.75	Professional		$12.49	$38.61	$97.75
Aetna Facility/Professional Professional Modifier 50 Low / Median / High Price $21.39 / $86.92 / $212.50	Professional	50	$21.39	$86.92	$212.50
Aetna Facility/Professional Professional Modifier 52 Low / Median / High Price $6.25 / $7.17 / $38.47	Professional	52	$6.25	$7.17	$38.47
Aetna Facility/Professional Professional Modifier 53 Low / Median / High Price $2.34 / $2.87 / $11.51	Professional	53	$2.34	$2.87	$11.51
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 $13.58 / $36.57 / $81.62	Professional		$13.58	$36.57	$81.62
Anthem BCBS Facility/Professional Professional Modifier 50 Low / Median / High Price $20.37 / $58.44 / $122.43	Professional	50	$20.37	$58.44	$122.43
CareSource Facility/Professional Facility Modifier Low / Median / High Price $13.89 / $19.89 / $19.89	Facility		$13.89	$19.89	$19.89
CareSource Facility/Professional Professional Modifier Low / Median / High Price $14.57 / $19.89 / $30.75	Professional		$14.57	$19.89	$30.75
Cigna Facility/Professional Facility Modifier Low / Median / High Price $43.25 / $50.55 / $81.53	Facility		$43.25	$50.55	$81.53
Cigna Facility/Professional Professional Modifier Low / Median / High Price $21.38 / $46.37 / $67.29	Professional		$21.38	$46.37	$67.29
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $14.30 / $18.37 / $30.85	Facility		$14.30	$18.37	$30.85
Medica Facility/Professional Facility Modifier Low / Median / High Price $15.79 / $155.00 / $1,789.00	Facility		$15.79	$155.00	$1,789.00
Medica Facility/Professional Professional Modifier Low / Median / High Price $14.44 / $33.68 / $78.13	Professional		$14.44	$33.68	$78.13
Molina Facility/Professional Professional Modifier Low / Median / High Price $48.90 / $58.40 / $85.00	Professional		$48.90	$58.40	$85.00
Prevea360 Facility/Professional Facility Modifier Low / Median / High Price $14.30 / $18.37 / $30.85	Facility		$14.30	$18.37	$30.85
Quartz Facility/Professional Professional Modifier Low / Median / High Price $30.55 / $46.96 / $55.57	Professional		$30.55	$46.96	$55.57
Quartz Facility/Professional Facility Modifier Low / Median / High Price $71.14 / $71.14 / $71.14	Facility		$71.14	$71.14	$71.14
Quartz Facility/Professional Professional Modifier Low / Median / High Price $22.47 / $67.86 / $116.72	Professional		$22.47	$67.86	$116.72
Security Health Facility/Professional Professional Modifier Low / Median / High Price $41.84 / $90.60 / $90.60	Professional		$41.84	$90.60	$90.60
United Facility/Professional Facility Modifier Low / Median / High Price $1,034.00 / $1,423.00 / $2,202.90	Facility		$1,034.00	$1,423.00	$2,202.90
United Facility/Professional Professional Modifier Low / Median / High Price $14.54 / $40.78 / $74.98	Professional		$14.54	$40.78	$74.98