Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $135.87 / $596.89 / $12,431.29	Facility		$135.87	$596.89	$12,431.29
Aetna Facility/Professional Professional Modifier Low / Median / High Price $135.87 / $211.72 / $854.15	Professional		$135.87	$211.72	$854.15
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 $215.58 / $469.51 / $963.97	Professional		$215.58	$469.51	$963.97
CareSource Facility/Professional Facility Modifier Low / Median / High Price $147.43 / $148.85 / $203.89	Facility		$147.43	$148.85	$203.89
CareSource Facility/Professional Professional Modifier Low / Median / High Price $225.62 / $248.18 / $302.55	Professional		$225.62	$248.18	$302.55
Cigna Facility/Professional Facility Modifier Low / Median / High Price $659.62 / $770.82 / $1,182.45	Facility		$659.62	$770.82	$1,182.45
Cigna Facility/Professional Professional Modifier Low / Median / High Price $167.49 / $337.62 / $677.02	Professional		$167.49	$337.62	$677.02
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $158.97 / $293.31 / $664.20	Facility		$158.97	$293.31	$664.20
Medica Facility/Professional Facility Modifier Low / Median / High Price $170.00 / $439.56 / $1,590.00	Facility		$170.00	$439.56	$1,590.00
Medica Facility/Professional Professional Modifier Low / Median / High Price $228.35 / $477.90 / $1,204.00	Professional		$228.35	$477.90	$1,204.00
Molina Facility/Professional Professional Modifier Low / Median / High Price $123.44 / $216.72 / $492.74	Professional		$123.44	$216.72	$492.74
Prevea360 Facility/Professional Facility Modifier Low / Median / High Price $158.97 / $293.31 / $664.20	Facility		$158.97	$293.31	$664.20
Quartz Facility/Professional Professional Modifier Low / Median / High Price $355.28 / $535.70 / $795.12	Professional		$355.28	$535.70	$795.12
Quartz Facility/Professional Facility Modifier Low / Median / High Price $314.07 / $419.76 / $737.24	Facility		$314.07	$419.76	$737.24
Quartz Facility/Professional Professional Modifier Low / Median / High Price $207.20 / $785.45 / $1,827.60	Professional		$207.20	$785.45	$1,827.60
Security Health Facility/Professional Professional Modifier Low / Median / High Price $298.58 / $691.56 / $1,059.90	Professional		$298.58	$691.56	$1,059.90
United Facility/Professional Facility Modifier Low / Median / High Price $785.00 / $1,370.00 / $2,202.90	Facility		$785.00	$1,370.00	$2,202.90
United Facility/Professional Professional Modifier Low / Median / High Price $215.35 / $372.88 / $991.64	Professional		$215.35	$372.88	$991.64