Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $102.89 / $406.00 / $3,119.00	Facility		$102.89	$406.00	$3,119.00
Aetna Facility/Professional Professional Modifier Low / Median / High Price $49.93 / $109.82 / $503.26	Professional		$49.93	$109.82	$503.26
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 $86.96 / $195.96 / $483.00	Professional		$86.96	$195.96	$483.00
Anthem BCBS Facility/Professional Professional Modifier 50 Low / Median / High Price $145.22 / $307.60 / $727.38	Professional	50	$145.22	$307.60	$727.38
CareSource Facility/Professional Facility Modifier Low / Median / High Price $54.99 / $55.11 / $77.02	Facility		$54.99	$55.11	$77.02
CareSource Facility/Professional Professional Modifier Low / Median / High Price $118.57 / $130.43 / $158.57	Professional		$118.57	$130.43	$158.57
Cigna Facility/Professional Facility Modifier Low / Median / High Price $349.63 / $408.58 / $626.77	Facility		$349.63	$408.58	$626.77
Cigna Facility/Professional Professional Modifier Low / Median / High Price $68.34 / $147.03 / $355.85	Professional		$68.34	$147.03	$355.85
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $60.14 / $142.28 / $352.38	Facility		$60.14	$142.28	$352.38
Medica Facility/Professional Facility Modifier Low / Median / High Price $66.13 / $170.46 / $1,590.00	Facility		$66.13	$170.46	$1,590.00
Medica Facility/Professional Professional Modifier Low / Median / High Price $100.02 / $202.81 / $629.00	Professional		$100.02	$202.81	$629.00
Molina Facility/Professional Professional Modifier Low / Median / High Price $77.53 / $126.96 / $290.37	Professional		$77.53	$126.96	$290.37
Prevea360 Facility/Professional Facility Modifier Low / Median / High Price $60.14 / $142.28 / $352.38	Facility		$60.14	$142.28	$352.38
Quartz Facility/Professional Professional Modifier Low / Median / High Price $135.91 / $224.92 / $418.66	Professional		$135.91	$224.92	$418.66
Quartz Facility/Professional Facility Modifier Low / Median / High Price $116.28 / $155.41 / $282.72	Facility		$116.28	$155.41	$282.72
Quartz Facility/Professional Professional Modifier Low / Median / High Price $69.93 / $295.39 / $963.44	Professional		$69.93	$295.39	$963.44
Security Health Facility/Professional Professional Modifier Low / Median / High Price $134.22 / $256.76 / $559.85	Professional		$134.22	$256.76	$559.85
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 $104.49 / $189.06 / $453.93	Professional		$104.49	$189.06	$453.93