Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $68.81 / $304.12 / $3,119.00	Facility		$68.81	$304.12	$3,119.00
Aetna Facility/Professional Professional Modifier Low / Median / High Price $68.81 / $129.84 / $310.05	Professional		$68.81	$129.84	$310.05
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $1,183.00 / $3,483.00 / $5,962.00	Facility		$1,183.00	$3,483.00	$5,962.00
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $119.84 / $252.44 / $574.77	Professional		$119.84	$252.44	$574.77
CareSource Facility/Professional Facility Modifier Low / Median / High Price $75.97 / $91.01 / $102.38	Facility		$75.97	$91.01	$102.38
CareSource Facility/Professional Professional Modifier Low / Median / High Price $139.91 / $153.91 / $189.54	Professional		$139.91	$153.91	$189.54
Cigna Facility/Professional Facility Modifier Low / Median / High Price $410.01 / $479.13 / $735.00	Facility		$410.01	$479.13	$735.00
Cigna Facility/Professional Professional Modifier Low / Median / High Price $94.04 / $208.80 / $420.74	Professional		$94.04	$208.80	$420.74
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $82.71 / $167.90 / $419.76	Facility		$82.71	$167.90	$419.76
Medica Facility/Professional Facility Modifier Low / Median / High Price $89.95 / $227.91 / $5,169.00	Facility		$89.95	$227.91	$5,169.00
Medica Facility/Professional Professional Modifier Low / Median / High Price $143.65 / $270.32 / $2,596.44	Professional		$143.65	$270.32	$2,596.44
Molina Facility/Professional Professional Modifier Low / Median / High Price $97.44 / $159.30 / $366.38	Professional		$97.44	$159.30	$366.38
Prevea360 Facility/Professional Facility Modifier Low / Median / High Price $82.71 / $167.90 / $419.76	Facility		$82.71	$167.90	$419.76
Quartz Facility/Professional Professional Modifier Low / Median / High Price $185.56 / $286.17 / $496.55	Professional		$185.56	$286.17	$496.55
Quartz Facility/Professional Facility Modifier Low / Median / High Price $160.02 / $213.87 / $389.32	Facility		$160.02	$213.87	$389.32
Quartz Facility/Professional Professional Modifier Low / Median / High Price $105.30 / $347.40 / $2,873.06	Professional		$105.30	$347.40	$2,873.06
Security Health Facility/Professional Professional Modifier Low / Median / High Price $183.63 / $351.45 / $660.37	Professional		$183.63	$351.45	$660.37
United Facility/Professional Facility Modifier Low / Median / High Price $2,960.00 / $4,155.00 / $5,865.00	Facility		$2,960.00	$4,155.00	$5,865.00
United Facility/Professional Professional Modifier Low / Median / High Price $135.40 / $232.87 / $599.59	Professional		$135.40	$232.87	$599.59