Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $73.17 / $183.17 / $1,894.00	Facility		$73.17	$183.17	$1,894.00
Aetna Facility/Professional Professional Modifier Low / Median / High Price $73.17 / $134.41 / $629.00	Professional		$73.17	$134.41	$629.00
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 $125.91 / $261.52 / $564.30	Professional		$125.91	$261.52	$564.30
CareSource Facility/Professional Facility Modifier Low / Median / High Price $80.56 / $81.41 / $111.25	Facility		$80.56	$81.41	$111.25
CareSource Facility/Professional Professional Modifier Low / Median / High Price $137.13 / $150.84 / $182.86	Professional		$137.13	$150.84	$182.86
Cigna Facility/Professional Facility Modifier Low / Median / High Price $402.80 / $470.70 / $722.07	Facility		$402.80	$470.70	$722.07
Cigna Facility/Professional Professional Modifier Low / Median / High Price $90.26 / $191.12 / $410.74	Professional		$90.26	$191.12	$410.74
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $86.57 / $175.53 / $402.75	Facility		$86.57	$175.53	$402.75
Medica Facility/Professional Facility Modifier Low / Median / High Price $90.50 / $240.21 / $1,513.00	Facility		$90.50	$240.21	$1,513.00
Medica Facility/Professional Professional Modifier Low / Median / High Price $137.13 / $276.36 / $665.58	Professional		$137.13	$276.36	$665.58
Molina Facility/Professional Professional Modifier Low / Median / High Price $70.00 / $123.56 / $276.87	Professional		$70.00	$123.56	$276.87
Prevea360 Facility/Professional Facility Modifier Low / Median / High Price $86.57 / $175.53 / $402.75	Facility		$86.57	$175.53	$402.75
Quartz Facility/Professional Professional Modifier Low / Median / High Price $189.33 / $299.04 / $482.48	Professional		$189.33	$299.04	$482.48
Quartz Facility/Professional Facility Modifier Low / Median / High Price $171.78 / $229.58 / $410.68	Facility		$171.78	$229.58	$410.68
Quartz Facility/Professional Professional Modifier Low / Median / High Price $112.53 / $425.20 / $1,110.16	Professional		$112.53	$425.20	$1,110.16
Security Health Facility/Professional Professional Modifier Low / Median / High Price $198.78 / $375.56 / $645.33	Professional		$198.78	$375.56	$645.33
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 $130.63 / $226.18 / $585.98	Professional		$130.63	$226.18	$585.98