Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $41.27 / $565.15 / $1,894.00	Facility		$41.27	$565.15	$1,894.00
Aetna Facility/Professional Professional Modifier Low / Median / High Price $41.27 / $77.89 / $422.09	Professional		$41.27	$77.89	$422.09
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 $49.91 / $96.91 / $266.93	Professional		$49.91	$96.91	$266.93
CareSource Facility/Professional Facility Modifier Low / Median / High Price $39.01 / $48.48 / $97.29	Facility		$39.01	$48.48	$97.29
CareSource Facility/Professional Professional Modifier Low / Median / High Price $54.74 / $57.48 / $76.19	Professional		$54.74	$57.48	$76.19
Cigna Facility/Professional Facility Modifier Low / Median / High Price $160.40 / $187.44 / $287.54	Facility		$160.40	$187.44	$287.54
Cigna Facility/Professional Professional Modifier Low / Median / High Price $65.37 / $158.79 / $277.76	Professional		$65.37	$158.79	$277.76
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $41.27 / $67.23 / $127.94	Facility		$41.27	$67.23	$127.94
Medica Facility/Professional Facility Modifier Low / Median / High Price $42.39 / $90.53 / $1,449.00	Facility		$42.39	$90.53	$1,449.00
Medica Facility/Professional Professional Modifier Low / Median / High Price $68.04 / $139.78 / $613.73	Professional		$68.04	$139.78	$613.73
Molina Facility/Professional Professional Modifier Low / Median / High Price $41.03 / $81.91 / $156.20	Professional		$41.03	$81.91	$156.20
Prevea360 Facility/Professional Facility Modifier Low / Median / High Price $41.27 / $67.23 / $127.94	Facility		$41.27	$67.23	$127.94
Quartz Facility/Professional Professional Modifier Low / Median / High Price $94.57 / $138.05 / $203.48	Professional		$94.57	$138.05	$203.48
Quartz Facility/Professional Facility Modifier Low / Median / High Price $65.14 / $65.14 / $187.71	Facility		$65.14	$65.14	$187.71
Quartz Facility/Professional Professional Modifier Low / Median / High Price $88.54 / $257.31 / $613.73	Professional		$88.54	$257.31	$613.73
Security Health Facility/Professional Professional Modifier Low / Median / High Price $179.46 / $265.44 / $388.96	Professional		$179.46	$265.44	$388.96
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 $65.68 / $123.70 / $279.51	Professional		$65.68	$123.70	$279.51