Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $74.33 / $193.25 / $3,963.55	Facility		$74.33	$193.25	$3,963.55
Aetna Facility/Professional Professional Modifier Low / Median / High Price $65.56 / $118.75 / $366.00	Professional		$65.56	$118.75	$366.00
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 $85.64 / $184.39 / $384.24	Professional		$85.64	$184.39	$384.24
CareSource Facility/Professional Facility Modifier Low / Median / High Price $70.43 / $71.65 / $96.31	Facility		$70.43	$71.65	$96.31
CareSource Facility/Professional Professional Modifier Low / Median / High Price $85.89 / $94.48 / $114.60	Professional		$85.89	$94.48	$114.60
Cigna Facility/Professional Facility Modifier Low / Median / High Price $250.51 / $292.74 / $449.07	Facility		$250.51	$292.74	$449.07
Cigna Facility/Professional Professional Modifier Low / Median / High Price $74.37 / $139.71 / $253.66	Professional		$74.37	$139.71	$253.66
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $71.65 / $115.38 / $252.45	Facility		$71.65	$115.38	$252.45
Medica Facility/Professional Facility Modifier Low / Median / High Price $76.31 / $170.19 / $1,590.00	Facility		$76.31	$170.19	$1,590.00
Medica Facility/Professional Professional Modifier Low / Median / High Price $81.30 / $170.88 / $573.76	Professional		$81.30	$170.88	$573.76
Molina Facility/Professional Professional Modifier Low / Median / High Price $58.91 / $95.42 / $221.50	Professional		$58.91	$95.42	$221.50
Prevea360 Facility/Professional Facility Modifier Low / Median / High Price $71.65 / $115.38 / $252.45	Facility		$71.65	$115.38	$252.45
Quartz Facility/Professional Professional Modifier Low / Median / High Price $162.15 / $220.97 / $306.89	Professional		$162.15	$220.97	$306.89
Quartz Facility/Professional Facility Modifier Low / Median / High Price $151.18 / $202.05 / $352.73	Facility		$151.18	$202.05	$352.73
Quartz Facility/Professional Professional Modifier Low / Median / High Price $90.38 / $357.00 / $691.60	Professional		$90.38	$357.00	$691.60
Security Health Facility/Professional Professional Modifier Low / Median / High Price $134.59 / $309.33 / $401.43	Professional		$134.59	$309.33	$401.43
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 $80.09 / $133.87 / $344.24	Professional		$80.09	$133.87	$344.24