Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $105.25 / $343.58 / $3,692.79	Facility		$105.25	$343.58	$3,692.79
Aetna Facility/Professional Professional Modifier Low / Median / High Price $107.52 / $267.58 / $1,020.00	Professional		$107.52	$267.58	$1,020.00
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 $149.34 / $307.30 / $706.79	Professional		$149.34	$307.30	$706.79
CareSource Facility/Professional Facility Modifier Low / Median / High Price $93.71 / $94.60 / $128.97	Facility		$93.71	$94.60	$128.97
CareSource Facility/Professional Professional Modifier Low / Median / High Price $148.15 / $162.97 / $197.79	Professional		$148.15	$162.97	$197.79
Cigna Facility/Professional Facility Modifier Low / Median / High Price $435.24 / $508.61 / $780.23	Facility		$435.24	$508.61	$780.23
Cigna Facility/Professional Professional Modifier Low / Median / High Price $123.03 / $265.13 / $478.29	Professional		$123.03	$265.13	$478.29
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $102.09 / $193.08 / $439.53	Facility		$102.09	$193.08	$439.53
Medica Facility/Professional Facility Modifier Low / Median / High Price $113.52 / $283.80 / $1,642.00	Facility		$113.52	$283.80	$1,642.00
Medica Facility/Professional Professional Modifier Low / Median / High Price $164.27 / $305.13 / $800.00	Professional		$164.27	$305.13	$800.00
Molina Facility/Professional Professional Modifier Low / Median / High Price $77.53 / $153.09 / $328.83	Professional		$77.53	$153.09	$328.83
Prevea360 Facility/Professional Facility Modifier Low / Median / High Price $102.09 / $193.08 / $439.53	Facility		$102.09	$193.08	$439.53
Quartz Facility/Professional Professional Modifier Low / Median / High Price $224.03 / $345.13 / $519.26	Professional		$224.03	$345.13	$519.26
Quartz Facility/Professional Facility Modifier Low / Median / High Price $199.61 / $266.77 / $464.72	Facility		$199.61	$266.77	$464.72
Quartz Facility/Professional Professional Modifier Low / Median / High Price $169.81 / $499.30 / $1,206.08	Professional		$169.81	$499.30	$1,206.08
Security Health Facility/Professional Professional Modifier Low / Median / High Price $248.74 / $441.74 / $699.89	Professional		$248.74	$441.74	$699.89
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 $158.55 / $262.55 / $596.92	Professional		$158.55	$262.55	$596.92