Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $41.69 / $177.83 / $245.47	Facility		$41.69	$177.83	$245.47
Aetna Facility/Professional Professional Modifier Low / Median / High Price $48.98 / $169.82 / $575.44	Professional		$48.98	$169.82	$575.44
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 $81.28 / $181.97 / $446.68	Professional		$81.28	$181.97	$446.68
CareSource Facility/Professional Facility Modifier Low / Median / High Price $47.86 / $57.54 / $63.10	Facility		$47.86	$57.54	$63.10
CareSource Facility/Professional Professional Modifier Low / Median / High Price $109.65 / $117.49 / $147.91	Professional		$109.65	$117.49	$147.91
Cigna Facility/Professional Facility Modifier Low / Median / High Price $331.13 / $380.19 / $616.60	Facility		$331.13	$380.19	$616.60
Cigna Facility/Professional Professional Modifier Low / Median / High Price $57.54 / $134.90 / $346.74	Professional		$57.54	$134.90	$346.74
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $50.12 / $147.91 / $3,311.31	Facility		$50.12	$147.91	$3,311.31
DeanCare Facility/Professional Professional Modifier Low / Median / High Price $93.33 / $173.78 / $354.81	Professional		$93.33	$173.78	$354.81
Medica Facility/Professional Facility Modifier Low / Median / High Price $51.29 / $147.91 / $1,659.59	Facility		$51.29	$147.91	$1,659.59
Medica Facility/Professional Professional Modifier Low / Median / High Price $97.72 / $234.42 / $575.44	Professional		$97.72	$234.42	$575.44
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.36 / $33.11 / $147.91	Professional		$32.36	$33.11	$147.91
Quartz Facility/Professional Professional Modifier Low / Median / High Price $81.28 / $151.36 / $380.19	Professional		$81.28	$151.36	$380.19
Quartz Facility/Professional Facility Modifier Low / Median / High Price $316.23 / $2,187.76 / $2,187.76	Facility		$316.23	$2,187.76	$2,187.76
Quartz Facility/Professional Professional Modifier Low / Median / High Price $52.48 / $138.04 / $870.96	Professional		$52.48	$138.04	$870.96
Security Health Facility/Professional Professional Modifier Low / Median / High Price $117.49 / $218.78 / $524.81	Professional		$117.49	$218.78	$524.81
United Facility/Professional Facility Modifier Low / Median / High Price $977.24 / $1,548.82 / $1,949.84	Facility		$977.24	$1,548.82	$1,949.84
United Facility/Professional Professional Modifier Low / Median / High Price $53.70 / $128.82 / $398.11	Professional		$53.70	$128.82	$398.11