Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $109.65 / $954.99 / $3,090.30	Facility		$109.65	$954.99	$3,090.30
Aetna Facility/Professional Professional Modifier Low / Median / High Price $70.79 / $144.54 / $426.58	Professional		$70.79	$144.54	$426.58
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 $120.23 / $234.42 / $501.19	Professional		$120.23	$234.42	$501.19
CareSource Facility/Professional Facility Modifier Low / Median / High Price $104.71 / $104.71 / $104.71	Facility		$104.71	$104.71	$104.71
CareSource Facility/Professional Professional Modifier Low / Median / High Price $117.49 / $125.89 / $158.49	Professional		$117.49	$125.89	$158.49
Cigna Facility/Professional Facility Modifier Low / Median / High Price $346.74 / $407.38 / $645.65	Facility		$346.74	$407.38	$645.65
Cigna Facility/Professional Professional Modifier Low / Median / High Price $91.20 / $204.17 / $389.05	Professional		$91.20	$204.17	$389.05
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $83.18 / $234.42 / $3,311.31	Facility		$83.18	$234.42	$3,311.31
DeanCare Facility/Professional Professional Modifier Low / Median / High Price $154.88 / $234.42 / $380.19	Professional		$154.88	$234.42	$380.19
Medica Facility/Professional Facility Modifier Low / Median / High Price $83.18 / $234.42 / $3,630.78	Facility		$83.18	$234.42	$3,630.78
Medica Facility/Professional Professional Modifier Low / Median / High Price $117.49 / $213.80 / $933.25	Professional		$117.49	$213.80	$933.25
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.36 / $33.11 / $229.09	Professional		$32.36	$33.11	$229.09
Quartz Facility/Professional Professional Modifier Low / Median / High Price $147.91 / $251.19 / $416.87	Professional		$147.91	$251.19	$416.87
Quartz Facility/Professional Facility Modifier Low / Median / High Price $489.78 / $2,041.74 / $2,041.74	Facility		$489.78	$2,041.74	$2,041.74
Quartz Facility/Professional Professional Modifier Low / Median / High Price $83.18 / $158.49 / $912.01	Professional		$83.18	$158.49	$912.01
Security Health Facility/Professional Professional Modifier Low / Median / High Price $147.91 / $363.08 / $549.54	Professional		$147.91	$363.08	$549.54
United Facility/Professional Facility Modifier Low / Median / High Price $2,238.72 / $2,818.38 / $4,677.35	Facility		$2,238.72	$2,818.38	$4,677.35
United Facility/Professional Professional Modifier Low / Median / High Price $83.18 / $158.49 / $416.87	Professional		$83.18	$158.49	$416.87