Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $136.52 / $296.39 / $817.48	Facility		$136.52	$296.39	$817.48
Aetna Facility/Professional Professional Modifier Low / Median / High Price $136.52 / $214.20 / $707.02	Professional		$136.52	$214.20	$707.02
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $1,183.00 / $3,483.00 / $5,962.00	Facility		$1,183.00	$3,483.00	$5,962.00
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $169.34 / $302.66 / $813.75	Professional		$169.34	$302.66	$813.75
CareSource Facility/Professional Facility Modifier Low / Median / High Price $391.17 / $391.17 / $391.17	Facility		$391.17	$391.17	$391.17
Cigna Facility/Professional Facility Modifier Low / Median / High Price $588.42 / $687.63 / $1,054.83	Facility		$588.42	$687.63	$1,054.83
Cigna Facility/Professional Professional Modifier Low / Median / High Price $238.26 / $544.50 / $948.26	Professional		$238.26	$544.50	$948.26
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $131.72 / $214.75 / $458.69	Facility		$131.72	$214.75	$458.69
Medica Facility/Professional Facility Modifier Low / Median / High Price $131.72 / $260.94 / $3,034.00	Facility		$131.72	$260.94	$3,034.00
Medica Facility/Professional Professional Modifier Low / Median / High Price $223.76 / $478.92 / $1,672.81	Professional		$223.76	$478.92	$1,672.81
Molina Facility/Professional Professional Modifier Low / Median / High Price $116.85 / $236.55 / $498.27	Professional		$116.85	$236.55	$498.27
Prevea360 Facility/Professional Facility Modifier Low / Median / High Price $131.72 / $214.75 / $458.69	Facility		$131.72	$214.75	$458.69
Quartz Facility/Professional Professional Modifier Low / Median / High Price $334.83 / $498.53 / $755.46	Professional		$334.83	$498.53	$755.46
Quartz Facility/Professional Facility Modifier Low / Median / High Price $304.41 / $304.41 / $669.20	Facility		$304.41	$304.41	$669.20
Quartz Facility/Professional Professional Modifier Low / Median / High Price $299.50 / $934.02 / $1,672.81	Professional		$299.50	$934.02	$1,672.81
Security Health Facility/Professional Professional Modifier Low / Median / High Price $457.64 / $457.64 / $724.92	Professional		$457.64	$457.64	$724.92
Security Health Facility/Professional Professional Modifier Low / Median / High Price $441.69 / $902.75 / $1,412.04	Professional		$441.69	$902.75	$1,412.04
United Facility/Professional Facility Modifier Low / Median / High Price $1,957.00 / $3,068.00 / $4,295.00	Facility		$1,957.00	$3,068.00	$4,295.00
United Facility/Professional Professional Modifier Low / Median / High Price $220.58 / $399.50 / $919.84	Professional		$220.58	$399.50	$919.84