Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $89.30 / $321.98 / $3,012.80	Facility		$89.30	$321.98	$3,012.80
Aetna Facility/Professional Professional Modifier Low / Median / High Price $89.30 / $182.26 / $642.00	Professional		$89.30	$182.26	$642.00
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 $139.03 / $299.19 / $610.15	Professional		$139.03	$299.19	$610.15
CareSource Facility/Professional Facility Modifier Low / Median / High Price $96.70 / $97.91 / $133.53	Facility		$96.70	$97.91	$133.53
CareSource Facility/Professional Professional Modifier Low / Median / High Price $143.10 / $157.41 / $191.61	Professional		$143.10	$157.41	$191.61
Cigna Facility/Professional Facility Modifier Low / Median / High Price $421.72 / $492.82 / $756.00	Facility		$421.72	$492.82	$756.00
Cigna Facility/Professional Professional Modifier Low / Median / High Price $107.37 / $222.55 / $431.45	Professional		$107.37	$222.55	$431.45
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $104.48 / $186.03 / $420.72	Facility		$104.48	$186.03	$420.72
Medica Facility/Professional Facility Modifier Low / Median / High Price $108.85 / $286.20 / $1,590.00	Facility		$108.85	$286.20	$1,590.00
Medica Facility/Professional Professional Modifier Low / Median / High Price $142.53 / $287.50 / $791.20	Professional		$142.53	$287.50	$791.20
Molina Facility/Professional Professional Modifier Low / Median / High Price $77.53 / $126.96 / $294.25	Professional		$77.53	$126.96	$294.25
Prevea360 Facility/Professional Facility Modifier Low / Median / High Price $104.48 / $186.03 / $420.72	Facility		$104.48	$186.03	$420.72
Quartz Facility/Professional Professional Modifier Low / Median / High Price $233.83 / $352.26 / $505.20	Professional		$233.83	$352.26	$505.20
Quartz Facility/Professional Facility Modifier Low / Median / High Price $206.59 / $276.11 / $485.92	Facility		$206.59	$276.11	$485.92
Quartz Facility/Professional Professional Modifier Low / Median / High Price $136.56 / $501.70 / $1,164.40	Professional		$136.56	$501.70	$1,164.40
Security Health Facility/Professional Professional Modifier Low / Median / High Price $189.29 / $455.81 / $676.24	Professional		$189.29	$455.81	$676.24
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 $137.40 / $224.37 / $575.33	Professional		$137.40	$224.37	$575.33