Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $72.44 / $181.97 / $1,905.46	Facility		$72.44	$181.97	$1,905.46
Aetna Facility/Professional Professional Modifier Low / Median / High Price $75.86 / $158.49 / $630.96	Professional		$75.86	$158.49	$630.96
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $1,584.89 / $3,090.30 / $5,754.40	Facility		$1,584.89	$3,090.30	$5,754.40
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $138.04 / $245.47 / $575.44	Professional		$138.04	$245.47	$575.44
CareSource Facility/Professional Facility Modifier Low / Median / High Price $83.18 / $100.00 / $109.65	Facility		$83.18	$100.00	$109.65
CareSource Facility/Professional Professional Modifier Low / Median / High Price $138.04 / $147.91 / $181.97	Professional		$138.04	$147.91	$181.97
Cigna Facility/Professional Facility Modifier Low / Median / High Price $407.38 / $467.74 / $758.58	Facility		$407.38	$467.74	$758.58
Cigna Facility/Professional Professional Modifier Low / Median / High Price $100.00 / $229.09 / $407.38	Professional		$100.00	$229.09	$407.38
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $85.11 / $245.47 / $3,311.31	Facility		$85.11	$245.47	$3,311.31
DeanCare Facility/Professional Professional Modifier Low / Median / High Price $162.18 / $269.15 / $446.68	Professional		$162.18	$269.15	$446.68
Medica Facility/Professional Facility Modifier Low / Median / High Price $87.10 / $245.47 / $1,659.59	Facility		$87.10	$245.47	$1,659.59
Medica Facility/Professional Professional Modifier Low / Median / High Price $138.04 / $269.15 / $676.08	Professional		$138.04	$269.15	$676.08
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.36 / $33.11 / $269.15	Professional		$32.36	$33.11	$269.15
Quartz Facility/Professional Professional Modifier Low / Median / High Price $144.54 / $257.04 / $478.63	Professional		$144.54	$257.04	$478.63
Quartz Facility/Professional Facility Modifier Low / Median / High Price $316.23 / $1,288.25 / $1,288.25	Facility		$316.23	$1,288.25	$1,288.25
Quartz Facility/Professional Professional Modifier Low / Median / High Price $89.13 / $186.21 / $1,071.52	Professional		$89.13	$186.21	$1,071.52
Security Health Facility/Professional Professional Modifier Low / Median / High Price $199.53 / $371.54 / $645.65	Professional		$199.53	$371.54	$645.65
United Facility/Professional Facility Modifier Low / Median / High Price $977.24 / $1,548.82 / $1,949.84	Facility		$977.24	$1,548.82	$1,949.84
United Facility/Professional Professional Modifier Low / Median / High Price $89.13 / $173.78 / $489.78	Professional		$89.13	$173.78	$489.78