Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $84.61 / $286.49 / $1,894.00	Facility		$84.61	$286.49	$1,894.00
Aetna Facility/Professional Professional Modifier Low / Median / High Price $96.17 / $225.48 / $901.00	Professional		$96.17	$225.48	$901.00
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 $151.53 / $289.73 / $645.23	Professional		$151.53	$289.73	$645.23
CareSource Facility/Professional Facility Modifier Low / Median / High Price $91.73 / $92.47 / $132.56	Facility		$91.73	$92.47	$132.56
CareSource Facility/Professional Professional Modifier Low / Median / High Price $127.33 / $140.06 / $178.31	Professional		$127.33	$140.06	$178.31
Cigna Facility/Professional Facility Modifier Low / Median / High Price $367.66 / $429.64 / $659.07	Facility		$367.66	$429.64	$659.07
Cigna Facility/Professional Professional Modifier Low / Median / High Price $151.91 / $256.70 / $409.63	Professional		$151.91	$256.70	$409.63
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $101.64 / $183.46 / $396.24	Facility		$101.64	$183.46	$396.24
Medica Facility/Professional Facility Modifier Low / Median / High Price $110.08 / $277.41 / $1,513.00	Facility		$110.08	$277.41	$1,513.00
Medica Facility/Professional Professional Modifier Low / Median / High Price $164.22 / $337.00 / $873.80	Professional		$164.22	$337.00	$873.80
Molina Facility/Professional Professional Modifier Low / Median / High Price $78.64 / $127.76 / $295.69	Professional		$78.64	$127.76	$295.69
Prevea360 Facility/Professional Facility Modifier Low / Median / High Price $101.64 / $183.46 / $396.24	Facility		$101.64	$183.46	$396.24
Quartz Facility/Professional Professional Modifier Low / Median / High Price $229.50 / $334.99 / $489.58	Professional		$229.50	$334.99	$489.58
Quartz Facility/Professional Facility Modifier Low / Median / High Price $193.55 / $258.68 / $469.26	Facility		$193.55	$258.68	$469.26
Quartz Facility/Professional Professional Modifier Low / Median / High Price $187.53 / $497.95 / $1,303.72	Professional		$187.53	$497.95	$1,303.72
Security Health Facility/Professional Professional Modifier Low / Median / High Price $320.24 / $426.89 / $599.46	Professional		$320.24	$426.89	$599.46
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 $149.77 / $282.64 / $610.98	Professional		$149.77	$282.64	$610.98