Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $112.49 / $392.92 / $6,461.00	Facility		$112.49	$392.92	$6,461.00
Aetna Facility/Professional Professional Modifier Low / Median / High Price $112.49 / $180.63 / $728.30	Professional		$112.49	$180.63	$728.30
Aetna Facility/Professional Professional Modifier 50 Low / Median / High Price $361.52 / $1,431.00 / $1,767.00	Professional	50	$361.52	$1,431.00	$1,767.00
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 $182.61 / $385.77 / $883.16	Professional		$182.61	$385.77	$883.16
Anthem BCBS Facility/Professional Professional Modifier 50 Low / Median / High Price $273.91 / $636.23 / $1,324.74	Professional	50	$273.91	$636.23	$1,324.74
Cigna Facility/Professional Facility Modifier Low / Median / High Price $516.34 / $603.39 / $973.24	Facility		$516.34	$603.39	$973.24
Cigna Facility/Professional Professional Modifier Low / Median / High Price $202.13 / $399.66 / $634.49	Professional		$202.13	$399.66	$634.49
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $112.49 / $180.63 / $375.45	Facility		$112.49	$180.63	$375.45
Medica Facility/Professional Facility Modifier Low / Median / High Price $122.63 / $255.65 / $1,778.00	Facility		$122.63	$255.65	$1,778.00
Medica Facility/Professional Professional Modifier Low / Median / High Price $210.16 / $570.25 / $1,197.35	Professional		$210.16	$570.25	$1,197.35
Molina Facility/Professional Professional Modifier Low / Median / High Price $83.91 / $250.42 / $395.19	Professional		$83.91	$250.42	$395.19
Prevea360 Facility/Professional Facility Modifier Low / Median / High Price $112.49 / $180.63 / $375.45	Facility		$112.49	$180.63	$375.45
Quartz Facility/Professional Professional Modifier Low / Median / High Price $279.91 / $431.46 / $641.91	Professional		$279.91	$431.46	$641.91
Quartz Facility/Professional Facility Modifier Low / Median / High Price $715.15 / $715.15 / $715.15	Facility		$715.15	$715.15	$715.15
Quartz Facility/Professional Professional Modifier Low / Median / High Price $170.46 / $817.29 / $1,422.08	Professional		$170.46	$817.29	$1,422.08
Security Health Facility/Professional Professional Modifier Low / Median / High Price $400.88 / $686.97 / $1,090.61	Professional		$400.88	$686.97	$1,090.61
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 $210.16 / $554.57 / $987.05	Professional		$210.16	$554.57	$987.05