Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $47.86 / $208.93 / $954.99	Facility		$47.86	$208.93	$954.99
Aetna Facility/Professional Professional Modifier Low / Median / High Price $53.70 / $165.96 / $436.52	Professional		$53.70	$165.96	$436.52
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 $87.10 / $177.83 / $416.87	Professional		$87.10	$177.83	$416.87
CareSource Facility/Professional Facility Modifier Low / Median / High Price $51.29 / $61.66 / $67.61	Facility		$51.29	$61.66	$67.61
CareSource Facility/Professional Professional Modifier Low / Median / High Price $104.71 / $114.82 / $141.25	Professional		$104.71	$114.82	$141.25
Cigna Facility/Professional Facility Modifier Low / Median / High Price $309.03 / $363.08 / $575.44	Facility		$309.03	$363.08	$575.44
Cigna Facility/Professional Professional Modifier Low / Median / High Price $61.66 / $144.54 / $346.74	Professional		$61.66	$144.54	$346.74
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $53.70 / $151.36 / $3,311.31	Facility		$53.70	$151.36	$3,311.31
DeanCare Facility/Professional Professional Modifier Low / Median / High Price $100.00 / $181.97 / $338.84	Professional		$100.00	$181.97	$338.84
Medica Facility/Professional Facility Modifier Low / Median / High Price $56.23 / $151.36 / $1,659.59	Facility		$56.23	$151.36	$1,659.59
Medica Facility/Professional Professional Modifier Low / Median / High Price $95.50 / $181.97 / $467.74	Professional		$95.50	$181.97	$467.74
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.36 / $33.11 / $151.36	Professional		$32.36	$33.11	$151.36
Quartz Facility/Professional Professional Modifier Low / Median / High Price $95.50 / $177.83 / $371.54	Professional		$95.50	$177.83	$371.54
Quartz Facility/Professional Facility Modifier Low / Median / High Price $346.74 / $1,737.80 / $1,737.80	Facility		$346.74	$1,737.80	$1,737.80
Quartz Facility/Professional Professional Modifier Low / Median / High Price $56.23 / $131.83 / $831.76	Professional		$56.23	$131.83	$831.76
Security Health Facility/Professional Professional Modifier Low / Median / High Price $123.03 / $229.09 / $501.19	Professional		$123.03	$229.09	$501.19
United Facility/Professional Facility Modifier Low / Median / High Price $977.24 / $1,548.82 / $1,949.84	Facility		$977.24	$1,548.82	$1,949.84
United Facility/Professional Professional Modifier Low / Median / High Price $57.54 / $128.82 / $338.84	Professional		$57.54	$128.82	$338.84