Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $28.50 / $86.95 / $557.70	Facility		$28.50	$86.95	$557.70
Aetna Facility/Professional Professional Modifier Low / Median / High Price $29.21 / $92.18 / $540.03	Professional		$29.21	$92.18	$540.03
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 $54.44 / $129.13 / $383.95	Professional		$54.44	$129.13	$383.95
CareSource Facility/Professional Facility Modifier Low / Median / High Price $30.79 / $30.88 / $42.84	Facility		$30.79	$30.88	$42.84
CareSource Facility/Professional Professional Modifier Low / Median / High Price $90.94 / $100.03 / $120.00	Professional		$90.94	$100.03	$120.00
Cigna Facility/Professional Facility Modifier Low / Median / High Price $273.04 / $319.07 / $489.46	Facility		$273.04	$319.07	$489.46
Cigna Facility/Professional Professional Modifier Low / Median / High Price $35.79 / $97.25 / $281.77	Professional		$35.79	$97.25	$281.77
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $33.40 / $93.38 / $265.92	Facility		$33.40	$93.38	$265.92
Medica Facility/Professional Facility Modifier Low / Median / High Price $36.47 / $109.13 / $1,513.00	Facility		$36.47	$109.13	$1,513.00
Medica Facility/Professional Professional Modifier Low / Median / High Price $75.42 / $177.59 / $425.15	Professional		$75.42	$177.59	$425.15
Molina Facility/Professional Professional Modifier Low / Median / High Price $58.91 / $94.25 / $218.92	Professional		$58.91	$94.25	$218.92
Prevea360 Facility/Professional Facility Modifier Low / Median / High Price $33.40 / $93.38 / $265.92	Facility		$33.40	$93.38	$265.92
Quartz Facility/Professional Professional Modifier Low / Median / High Price $75.43 / $140.49 / $319.13	Professional		$75.43	$140.49	$319.13
Quartz Facility/Professional Facility Modifier Low / Median / High Price $65.16 / $87.08 / $163.47	Facility		$65.16	$87.08	$163.47
Quartz Facility/Professional Professional Modifier Low / Median / High Price $43.07 / $168.25 / $745.84	Professional		$43.07	$168.25	$745.84
Security Health Facility/Professional Professional Modifier Low / Median / High Price $76.98 / $143.75 / $435.26	Professional		$76.98	$143.75	$435.26
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 $82.96 / $150.29 / $363.79	Professional		$82.96	$150.29	$363.79