Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $162.00 / $577.01 / $4,479.35	Facility		$162.00	$577.01	$4,479.35
Aetna Facility/Professional Professional Modifier Low / Median / High Price $147.10 / $240.66 / $793.06	Professional		$147.10	$240.66	$793.06
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 $251.62 / $533.38 / $1,131.75	Professional		$251.62	$533.38	$1,131.75
CareSource Facility/Professional Facility Modifier Low / Median / High Price $175.88 / $177.20 / $244.30	Facility		$175.88	$177.20	$244.30
CareSource Facility/Professional Professional Modifier Low / Median / High Price $256.45 / $282.10 / $346.14	Professional		$256.45	$282.10	$346.14
Cigna Facility/Professional Facility Modifier Low / Median / High Price $746.13 / $871.91 / $1,337.53	Facility		$746.13	$871.91	$1,337.53
Cigna Facility/Professional Professional Modifier Low / Median / High Price $200.86 / $406.72 / $769.13	Professional		$200.86	$406.72	$769.13
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $189.54 / $333.39 / $758.04	Facility		$189.54	$333.39	$758.04
Medica Facility/Professional Facility Modifier Low / Median / High Price $204.73 / $524.40 / $3,593.00	Facility		$204.73	$524.40	$3,593.00
Medica Facility/Professional Professional Modifier Low / Median / High Price $262.67 / $543.88 / $1,435.68	Professional		$262.67	$543.88	$1,435.68
Molina Facility/Professional Professional Modifier Low / Median / High Price $26.80 / $167.00 / $524.74	Professional		$26.80	$167.00	$524.74
Prevea360 Facility/Professional Facility Modifier Low / Median / High Price $189.54 / $333.39 / $758.04	Facility		$189.54	$333.39	$758.04
Quartz Facility/Professional Professional Modifier Low / Median / High Price $424.67 / $629.61 / $906.55	Professional		$424.67	$629.61	$906.55
Quartz Facility/Professional Facility Modifier Low / Median / High Price $373.89 / $499.70 / $902.84	Facility		$373.89	$499.70	$902.84
Quartz Facility/Professional Professional Modifier Low / Median / High Price $246.56 / $938.45 / $2,078.96	Professional		$246.56	$938.45	$2,078.96
Security Health Facility/Professional Professional Modifier Low / Median / High Price $357.37 / $822.90 / $1,202.85	Professional		$357.37	$822.90	$1,202.85
United Facility/Professional Facility Modifier Low / Median / High Price $2,367.00 / $3,088.30 / $4,295.00	Facility		$2,367.00	$3,088.30	$4,295.00
United Facility/Professional Professional Modifier Low / Median / High Price $224.13 / $394.31 / $1,013.00	Professional		$224.13	$394.31	$1,013.00