Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $53.70 / $213.80 / $1,905.46	Facility		$53.70	$213.80	$1,905.46
Aetna Facility/Professional Professional Modifier Low / Median / High Price $35.48 / $102.33 / $380.19	Professional		$35.48	$102.33	$380.19
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $1,584.89 / $3,090.30 / $5,754.40	Facility		$1,584.89	$3,090.30	$5,754.40
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $60.26 / $141.25 / $363.08	Professional		$60.26	$141.25	$363.08
CareSource Facility/Professional Facility Modifier Low / Median / High Price $35.48 / $42.66 / $46.77	Facility		$35.48	$42.66	$46.77
CareSource Facility/Professional Professional Modifier Low / Median / High Price $91.20 / $97.72 / $120.23	Professional		$91.20	$97.72	$120.23
Cigna Facility/Professional Facility Modifier Low / Median / High Price $275.42 / $316.23 / $512.86	Facility		$275.42	$316.23	$512.86
Cigna Facility/Professional Professional Modifier Low / Median / High Price $42.66 / $112.20 / $302.00	Professional		$42.66	$112.20	$302.00
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $37.15 / $109.65 / $3,388.44	Facility		$37.15	$109.65	$3,388.44
DeanCare Facility/Professional Professional Modifier Low / Median / High Price $69.18 / $128.82 / $295.12	Professional		$69.18	$128.82	$295.12
Medica Facility/Professional Facility Modifier Low / Median / High Price $38.90 / $131.83 / $1,659.59	Facility		$38.90	$131.83	$1,659.59
Medica Facility/Professional Professional Modifier Low / Median / High Price $100.00 / $234.42 / $524.81	Professional		$100.00	$234.42	$524.81
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.36 / $33.11 / $70.79	Professional		$32.36	$33.11	$70.79
Quartz Facility/Professional Professional Modifier Low / Median / High Price $58.88 / $123.03 / $316.23	Professional		$58.88	$123.03	$316.23
Quartz Facility/Professional Facility Modifier Low / Median / High Price $281.84 / $281.84 / $407.38	Facility		$281.84	$281.84	$407.38
Quartz Facility/Professional Professional Modifier Low / Median / High Price $40.74 / $112.20 / $707.95	Professional		$40.74	$112.20	$707.95
Security Health Facility/Professional Professional Modifier Low / Median / High Price $72.44 / $177.83 / $436.52	Professional		$72.44	$177.83	$436.52
United Facility/Professional Facility Modifier Low / Median / High Price $1,023.29 / $1,548.82 / $1,949.84	Facility		$1,023.29	$1,548.82	$1,949.84
United Facility/Professional Professional Modifier Low / Median / High Price $41.69 / $112.20 / $331.13	Professional		$41.69	$112.20	$331.13