Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $109.81 / $455.20 / $774.20	Facility		$109.81	$455.20	$774.20
Aetna Facility/Professional Professional Modifier Low / Median / High Price $53.98 / $162.35 / $615.60	Professional		$53.98	$162.35	$615.60
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 $93.00 / $182.39 / $422.04	Professional		$93.00	$182.39	$422.04
CareSource Facility/Professional Facility Modifier Low / Median / High Price $51.61 / $52.26 / $75.61	Facility		$51.61	$52.26	$75.61
CareSource Facility/Professional Professional Modifier Low / Median / High Price $103.31 / $113.64 / $142.05	Professional		$103.31	$113.64	$142.05
Cigna Facility/Professional Facility Modifier Low / Median / High Price $300.97 / $351.71 / $539.54	Facility		$300.97	$351.71	$539.54
Cigna Facility/Professional Professional Modifier Low / Median / High Price $64.00 / $145.40 / $331.73	Professional		$64.00	$145.40	$331.73
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $57.57 / $132.24 / $312.00	Facility		$57.57	$132.24	$312.00
Medica Facility/Professional Facility Modifier Low / Median / High Price $64.84 / $210.17 / $1,449.00	Facility		$64.84	$210.17	$1,449.00
Medica Facility/Professional Professional Modifier Low / Median / High Price $106.87 / $212.81 / $499.00	Professional		$106.87	$212.81	$499.00
Molina Facility/Professional Professional Modifier Low / Median / High Price $58.91 / $95.42 / $218.92	Professional		$58.91	$95.42	$218.92
Prevea360 Facility/Professional Facility Modifier Low / Median / High Price $57.57 / $132.24 / $312.00	Facility		$57.57	$132.24	$312.00
Quartz Facility/Professional Professional Modifier Low / Median / High Price $131.25 / $200.11 / $371.06	Professional		$131.25	$200.11	$371.06
Quartz Facility/Professional Facility Modifier Low / Median / High Price $108.90 / $145.54 / $407.88	Facility		$108.90	$145.54	$407.88
Quartz Facility/Professional Professional Modifier Low / Median / High Price $72.45 / $281.85 / $923.60	Professional		$72.45	$281.85	$923.60
Security Health Facility/Professional Professional Modifier Low / Median / High Price $126.60 / $241.81 / $485.43	Professional		$126.60	$241.81	$485.43
United Facility/Professional Facility Modifier Low / Median / High Price $1,034.00 / $1,423.00 / $2,202.90	Facility		$1,034.00	$1,423.00	$2,202.90
United Facility/Professional Professional Modifier Low / Median / High Price $104.21 / $201.50 / $437.20	Professional		$104.21	$201.50	$437.20