Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $94.62 / $394.25 / $756.50	Facility		$94.62	$394.25	$756.50
Aetna Facility/Professional Professional Modifier Low / Median / High Price $48.93 / $124.94 / $592.72	Professional		$48.93	$124.94	$592.72
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 $86.64 / $175.47 / $419.80	Professional		$86.64	$175.47	$419.80
CareSource Facility/Professional Facility Modifier Low / Median / High Price $48.93 / $49.54 / $71.70	Facility		$48.93	$49.54	$71.70
CareSource Facility/Professional Professional Modifier Low / Median / High Price $101.56 / $111.72 / $139.35	Professional		$101.56	$111.72	$139.35
Cigna Facility/Professional Facility Modifier Low / Median / High Price $295.57 / $345.39 / $529.84	Facility		$295.57	$345.39	$529.84
Cigna Facility/Professional Professional Modifier Low / Median / High Price $66.22 / $145.07 / $326.13	Professional		$66.22	$145.07	$326.13
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $54.57 / $130.00 / $305.85	Facility		$54.57	$130.00	$305.85
Medica Facility/Professional Facility Modifier Low / Median / High Price $60.69 / $207.00 / $1,449.00	Facility		$60.69	$207.00	$1,449.00
Medica Facility/Professional Professional Modifier Low / Median / High Price $107.70 / $214.00 / $499.00	Professional		$107.70	$214.00	$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 $54.57 / $130.00 / $305.85	Facility		$54.57	$130.00	$305.85
Quartz Facility/Professional Professional Modifier Low / Median / High Price $122.95 / $196.61 / $364.57	Professional		$122.95	$196.61	$364.57
Quartz Facility/Professional Facility Modifier Low / Median / High Price $103.24 / $137.97 / $384.54	Facility		$103.24	$137.97	$384.54
Quartz Facility/Professional Professional Modifier Low / Median / High Price $97.57 / $265.20 / $918.11	Professional		$97.57	$265.20	$918.11
Security Health Facility/Professional Professional Modifier Low / Median / High Price $118.70 / $227.79 / $477.24	Professional		$118.70	$227.79	$477.24
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 $99.44 / $169.40 / $415.31	Professional		$99.44	$169.40	$415.31