Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $123.53 / $415.58 / $6,461.00	Facility		$123.53	$415.58	$6,461.00
Aetna Facility/Professional Professional Modifier Low / Median / High Price $123.53 / $215.80 / $1,374.30	Professional		$123.53	$215.80	$1,374.30
Aetna Facility/Professional Professional Modifier 50 Low / Median / High Price $1,031.63 / $1,410.00 / $2,068.53	Professional	50	$1,031.63	$1,410.00	$2,068.53
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 $192.93 / $422.65 / $932.51	Professional		$192.93	$422.65	$932.51
Anthem BCBS Facility/Professional Professional Modifier 50 Low / Median / High Price $293.05 / $690.48 / $1,405.71	Professional	50	$293.05	$690.48	$1,405.71
CareSource Facility/Professional Facility Modifier Low / Median / High Price $124.14 / $184.10 / $184.10	Facility		$124.14	$184.10	$184.10
CareSource Facility/Professional Professional Modifier Low / Median / High Price $190.04 / $268.16 / $414.49	Professional		$190.04	$268.16	$414.49
Cigna Facility/Professional Facility Modifier Low / Median / High Price $546.08 / $638.14 / $1,029.29	Facility		$546.08	$638.14	$1,029.29
Cigna Facility/Professional Professional Modifier Low / Median / High Price $216.42 / $438.50 / $679.17	Professional		$216.42	$438.50	$679.17
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $123.53 / $215.80 / $397.11	Facility		$123.53	$215.80	$397.11
Medica Facility/Professional Facility Modifier Low / Median / High Price $146.97 / $273.00 / $1,778.00	Facility		$146.97	$273.00	$1,778.00
Medica Facility/Professional Professional Modifier Low / Median / High Price $222.48 / $602.48 / $1,265.77	Professional		$222.48	$602.48	$1,265.77
Molina Facility/Professional Professional Modifier Low / Median / High Price $92.59 / $262.94 / $439.36	Professional		$92.59	$262.94	$439.36
Prevea360 Facility/Professional Facility Modifier Low / Median / High Price $123.53 / $215.80 / $397.11	Facility		$123.53	$215.80	$397.11
Quartz Facility/Professional Professional Modifier Low / Median / High Price $307.37 / $457.65 / $679.02	Professional		$307.37	$457.65	$679.02
Quartz Facility/Professional Facility Modifier Low / Median / High Price $610.08 / $610.08 / $610.08	Facility		$610.08	$610.08	$610.08
Quartz Facility/Professional Professional Modifier Low / Median / High Price $187.02 / $864.45 / $1,506.00	Professional		$187.02	$864.45	$1,506.00
Security Health Facility/Professional Professional Modifier Low / Median / High Price $440.16 / $753.76 / $1,153.56	Professional		$440.16	$753.76	$1,153.56
United Facility/Professional Facility Modifier Low / Median / High Price $1,008.00 / $1,423.00 / $2,202.90	Facility		$1,008.00	$1,423.00	$2,202.90
United Facility/Professional Professional Modifier Low / Median / High Price $213.76 / $609.72 / $1,042.21	Professional		$213.76	$609.72	$1,042.21