Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $92.98 / $415.71 / $1,894.00	Facility		$92.98	$415.71	$1,894.00
Aetna Facility/Professional Professional Modifier Low / Median / High Price $93.88 / $179.64 / $803.25	Professional		$93.88	$179.64	$803.25
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 $153.22 / $330.69 / $692.94	Professional		$153.22	$330.69	$692.94
CareSource Facility/Professional Facility Modifier Low / Median / High Price $101.46 / $102.42 / $140.06	Facility		$101.46	$102.42	$140.06
CareSource Facility/Professional Professional Modifier Low / Median / High Price $164.64 / $181.10 / $220.02	Professional		$164.64	$181.10	$220.02
Cigna Facility/Professional Facility Modifier Low / Median / High Price $482.10 / $563.37 / $864.23	Facility		$482.10	$563.37	$864.23
Cigna Facility/Professional Professional Modifier Low / Median / High Price $114.94 / $235.40 / $494.43	Professional		$114.94	$235.40	$494.43
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $109.20 / $210.74 / $484.23	Facility		$109.20	$210.74	$484.23
Medica Facility/Professional Facility Modifier Low / Median / High Price $113.17 / $304.38 / $1,513.00	Facility		$113.17	$304.38	$1,513.00
Medica Facility/Professional Professional Modifier Low / Median / High Price $164.64 / $340.39 / $826.80	Professional		$164.64	$340.39	$826.80
Molina Facility/Professional Professional Modifier Low / Median / High Price $83.91 / $186.31 / $414.76	Professional		$83.91	$186.31	$414.76
Prevea360 Facility/Professional Facility Modifier Low / Median / High Price $109.20 / $210.74 / $484.23	Facility		$109.20	$210.74	$484.23
Quartz Facility/Professional Professional Modifier Low / Median / High Price $241.38 / $375.48 / $578.76	Professional		$241.38	$375.48	$578.76
Quartz Facility/Professional Facility Modifier Low / Median / High Price $216.11 / $288.82 / $518.88	Facility		$216.11	$288.82	$518.88
Quartz Facility/Professional Professional Modifier Low / Median / High Price $142.18 / $544.29 / $1,335.04	Professional		$142.18	$544.29	$1,335.04
Security Health Facility/Professional Professional Modifier Low / Median / High Price $252.94 / $474.51 / $774.73	Professional		$252.94	$474.51	$774.73
United Facility/Professional Facility Modifier Low / Median / High Price $1,008.00 / $1,507.00 / $2,202.90	Facility		$1,008.00	$1,507.00	$2,202.90
United Facility/Professional Professional Modifier Low / Median / High Price $158.21 / $268.64 / $673.83	Professional		$158.21	$268.64	$673.83