Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $83.33 / $216.79 / $1,894.00	Facility		$83.33	$216.79	$1,894.00
Aetna Facility/Professional Professional Modifier Low / Median / High Price $85.96 / $161.25 / $722.10	Professional		$85.96	$161.25	$722.10
Aetna Facility/Professional Professional Modifier 22 Low / Median / High Price $799.01 / $799.01 / $799.01	Professional	22	$799.01	$799.01	$799.01
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 $117.63 / $229.78 / $541.79	Professional		$117.63	$229.78	$541.79
CareSource Facility/Professional Facility Modifier Low / Median / High Price $90.07 / $90.91 / $124.73	Facility		$90.07	$90.91	$124.73
CareSource Facility/Professional Professional Modifier Low / Median / High Price $153.44 / $168.78 / $205.08	Professional		$153.44	$168.78	$205.08
Cigna Facility/Professional Facility Modifier Low / Median / High Price $453.26 / $529.66 / $812.53	Facility		$453.26	$529.66	$812.53
Cigna Facility/Professional Professional Modifier Low / Median / High Price $109.24 / $229.36 / $466.86	Professional		$109.24	$229.36	$466.86
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $98.07 / $197.32 / $455.73	Facility		$98.07	$197.32	$455.73
Medica Facility/Professional Facility Modifier Low / Median / High Price $109.09 / $272.73 / $1,513.00	Facility		$109.09	$272.73	$1,513.00
Medica Facility/Professional Professional Modifier Low / Median / High Price $160.78 / $306.48 / $802.80	Professional		$160.78	$306.48	$802.80
Molina Facility/Professional Professional Modifier Low / Median / High Price $77.53 / $126.96 / $294.25	Professional		$77.53	$126.96	$294.25
Prevea360 Facility/Professional Facility Modifier Low / Median / High Price $98.07 / $197.32 / $455.73	Facility		$98.07	$197.32	$455.73
Quartz Facility/Professional Professional Modifier Low / Median / High Price $214.22 / $335.01 / $540.90	Professional		$214.22	$335.01	$540.90
Quartz Facility/Professional Facility Modifier Low / Median / High Price $191.82 / $256.37 / $462.24	Facility		$191.82	$256.37	$462.24
Quartz Facility/Professional Professional Modifier Low / Median / High Price $126.59 / $476.80 / $1,248.48	Professional		$126.59	$476.80	$1,248.48
Security Health Facility/Professional Professional Modifier Low / Median / High Price $216.11 / $422.54 / $725.62	Professional		$216.11	$422.54	$725.62
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 $149.55 / $238.64 / $570.83	Professional		$149.55	$238.64	$570.83