Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $147.68 / $319.55 / $1,894.00	Facility		$147.68	$319.55	$1,894.00
Aetna Facility/Professional Professional Modifier Low / Median / High Price $139.65 / $152.80 / $662.17	Professional		$139.65	$152.80	$662.17
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 $137.55 / $340.79 / $887.91	Professional		$137.55	$340.79	$887.91
CareSource Facility/Professional Facility Modifier Low / Median / High Price $319.44 / $319.44 / $319.44	Facility		$319.44	$319.44	$319.44
Cigna Facility/Professional Facility Modifier Low / Median / High Price $410.01 / $479.13 / $735.00	Facility		$410.01	$479.13	$735.00
Cigna Facility/Professional Professional Modifier Low / Median / High Price $184.40 / $548.48 / $702.78	Professional		$184.40	$548.48	$702.78
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $147.68 / $210.00 / $326.37	Facility		$147.68	$210.00	$326.37
Medica Facility/Professional Facility Modifier Low / Median / High Price $147.68 / $231.19 / $1,449.00	Facility		$147.68	$231.19	$1,449.00
Medica Facility/Professional Professional Modifier Low / Median / High Price $150.85 / $320.30 / $1,141.11	Professional		$150.85	$320.30	$1,141.11
Molina Facility/Professional Professional Modifier Low / Median / High Price $28.95 / $92.82 / $281.96	Professional		$28.95	$92.82	$281.96
Prevea360 Facility/Professional Facility Modifier Low / Median / High Price $147.68 / $210.00 / $326.37	Facility		$147.68	$210.00	$326.37
Quartz Facility/Professional Professional Modifier Low / Median / High Price $308.75 / $380.10 / $556.40	Professional		$308.75	$380.10	$556.40
Quartz Facility/Professional Facility Modifier Low / Median / High Price $264.92 / $264.92 / $1,256.64	Facility		$264.92	$264.92	$1,256.64
Quartz Facility/Professional Professional Modifier Low / Median / High Price $280.66 / $692.65 / $1,141.11	Professional		$280.66	$692.65	$1,141.11
Security Health Facility/Professional Professional Modifier Low / Median / High Price $476.27 / $476.27 / $486.32	Professional		$476.27	$476.27	$486.32
Security Health Facility/Professional Professional Modifier Low / Median / High Price $452.99 / $971.21 / $984.22	Professional		$452.99	$971.21	$984.22
United Facility/Professional Facility Modifier Low / Median / High Price $1,008.00 / $1,370.00 / $2,202.90	Facility		$1,008.00	$1,370.00	$2,202.90
United Facility/Professional Professional Modifier Low / Median / High Price $150.85 / $306.35 / $669.60	Professional		$150.85	$306.35	$669.60