Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $52.65 / $191.68 / $500.81	Facility		$52.65	$191.68	$500.81
Aetna Facility/Professional Professional Modifier Low / Median / High Price $52.90 / $117.40 / $527.00	Professional		$52.90	$117.40	$527.00
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 $91.69 / $204.46 / $510.47	Professional		$91.69	$204.46	$510.47
CareSource Facility/Professional Facility Modifier Low / Median / High Price $57.01 / $57.09 / $79.76	Facility		$57.01	$57.09	$79.76
CareSource Facility/Professional Professional Modifier Low / Median / High Price $124.89 / $137.38 / $166.87	Professional		$124.89	$137.38	$166.87
Cigna Facility/Professional Facility Modifier Low / Median / High Price $369.46 / $431.74 / $662.30	Facility		$369.46	$431.74	$662.30
Cigna Facility/Professional Professional Modifier Low / Median / High Price $67.31 / $158.13 / $355.89	Professional		$67.31	$158.13	$355.89
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $61.90 / $149.87 / $366.96	Facility		$61.90	$149.87	$366.96
Medica Facility/Professional Facility Modifier Low / Median / High Price $67.03 / $171.27 / $1,513.00	Facility		$67.03	$171.27	$1,513.00
Medica Facility/Professional Professional Modifier Low / Median / High Price $109.15 / $214.55 / $583.35	Professional		$109.15	$214.55	$583.35
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 $61.90 / $149.87 / $366.96	Facility		$61.90	$149.87	$366.96
Quartz Facility/Professional Professional Modifier Low / Median / High Price $140.40 / $236.55 / $440.29	Professional		$140.40	$236.55	$440.29
Quartz Facility/Professional Facility Modifier Low / Median / High Price $120.46 / $160.99 / $284.58	Facility		$120.46	$160.99	$284.58
Quartz Facility/Professional Professional Modifier Low / Median / High Price $79.56 / $311.05 / $1,018.00	Professional		$79.56	$311.05	$1,018.00
Security Health Facility/Professional Professional Modifier Low / Median / High Price $142.53 / $265.51 / $591.83	Professional		$142.53	$265.51	$591.83
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 $109.26 / $205.22 / $495.85	Professional		$109.26	$205.22	$495.85