Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $51.06 / $232.00 / $677.20	Facility		$51.06	$232.00	$677.20
Aetna Facility/Professional Professional Modifier Low / Median / High Price $47.91 / $73.64 / $284.00	Professional		$47.91	$73.64	$284.00
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 $62.99 / $95.38 / $246.73	Professional		$62.99	$95.38	$246.73
CareSource Facility/Professional Facility Modifier Low / Median / High Price $50.34 / $51.22 / $68.67	Facility		$50.34	$51.22	$68.67
CareSource Facility/Professional Professional Modifier Low / Median / High Price $63.29 / $69.62 / $84.19	Professional		$63.29	$69.62	$84.19
Cigna Facility/Professional Facility Modifier Low / Median / High Price $182.93 / $213.77 / $327.92	Facility		$182.93	$213.77	$327.92
Cigna Facility/Professional Professional Modifier Low / Median / High Price $55.44 / $113.23 / $201.00	Professional		$55.44	$113.23	$201.00
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $53.65 / $84.06 / $185.91	Facility		$53.65	$84.06	$185.91
Medica Facility/Professional Facility Modifier Low / Median / High Price $56.99 / $125.60 / $1,513.00	Facility		$56.99	$125.60	$1,513.00
Medica Facility/Professional Professional Modifier Low / Median / High Price $67.47 / $148.03 / $413.28	Professional		$67.47	$148.03	$413.28
Molina Facility/Professional Professional Modifier Low / Median / High Price $25.07 / $61.81 / $139.53	Professional		$25.07	$61.81	$139.53
Prevea360 Facility/Professional Facility Modifier Low / Median / High Price $53.65 / $84.06 / $185.91	Facility		$53.65	$84.06	$185.91
Quartz Facility/Professional Professional Modifier Low / Median / High Price $119.15 / $161.69 / $225.50	Professional		$119.15	$161.69	$225.50
Quartz Facility/Professional Facility Modifier Low / Median / High Price $108.07 / $144.44 / $260.56	Facility		$108.07	$144.44	$260.56
Quartz Facility/Professional Professional Modifier Low / Median / High Price $65.34 / $260.85 / $506.56	Professional		$65.34	$260.85	$506.56
Security Health Facility/Professional Professional Modifier Low / Median / High Price $115.28 / $239.04 / $294.11	Professional		$115.28	$239.04	$294.11
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 $66.18 / $106.62 / $253.92	Professional		$66.18	$106.62	$253.92