Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $125.10 / $408.80 / $6,254.95	Facility		$125.10	$408.80	$6,254.95
Aetna Facility/Professional Professional Modifier Low / Median / High Price $125.10 / $192.45 / $808.00	Professional		$125.10	$192.45	$808.00
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $1,314.00 / $2,550.00 / $4,471.00	Facility		$1,314.00	$2,550.00	$4,471.00
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $185.18 / $384.59 / $801.76	Professional		$185.18	$384.59	$801.76
CareSource Facility/Professional Facility Modifier Low / Median / High Price $136.97 / $138.36 / $190.44	Facility		$136.97	$138.36	$190.44
CareSource Facility/Professional Professional Modifier Low / Median / High Price $181.69 / $199.86 / $246.13	Professional		$181.69	$199.86	$246.13
Cigna Facility/Professional Facility Modifier Low / Median / High Price $530.76 / $620.23 / $951.46	Facility		$530.76	$620.23	$951.46
Cigna Facility/Professional Professional Modifier Low / Median / High Price $151.22 / $277.57 / $583.34	Professional		$151.22	$277.57	$583.34
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $146.37 / $236.20 / $539.01	Facility		$146.37	$236.20	$539.01
Medica Facility/Professional Facility Modifier Low / Median / High Price $157.59 / $377.20 / $3,593.00	Facility		$157.59	$377.20	$3,593.00
Medica Facility/Professional Professional Modifier Low / Median / High Price $181.69 / $368.32 / $1,116.56	Professional		$181.69	$368.32	$1,116.56
Molina Facility/Professional Professional Modifier Low / Median / High Price $97.44 / $182.69 / $395.01	Professional		$97.44	$182.69	$395.01
Prevea360 Facility/Professional Facility Modifier Low / Median / High Price $146.37 / $236.20 / $539.01	Facility		$146.37	$236.20	$539.01
Quartz Facility/Professional Professional Modifier Low / Median / High Price $328.12 / $468.06 / $645.83	Professional		$328.12	$468.06	$645.83
Quartz Facility/Professional Facility Modifier Low / Median / High Price $291.94 / $390.18 / $706.08	Facility		$291.94	$390.18	$706.08
Quartz Facility/Professional Professional Modifier Low / Median / High Price $189.97 / $709.60 / $1,475.04	Professional		$189.97	$709.60	$1,475.04
Security Health Facility/Professional Professional Modifier Low / Median / High Price $267.07 / $641.90 / $853.63	Professional		$267.07	$641.90	$853.63
United Facility/Professional Facility Modifier Low / Median / High Price $2,257.00 / $3,088.30 / $4,295.00	Facility		$2,257.00	$3,088.30	$4,295.00
United Facility/Professional Professional Modifier Low / Median / High Price $176.27 / $285.45 / $780.86	Professional		$176.27	$285.45	$780.86