Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $79.98 / $218.27 / $624.00	Facility		$79.98	$218.27	$624.00
Aetna Facility/Professional Professional Modifier Low / Median / High Price $79.79 / $129.07 / $459.75	Professional		$79.79	$129.07	$459.75
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 $98.32 / $184.57 / $499.41	Professional		$98.32	$184.57	$499.41
CareSource Facility/Professional Facility Modifier Low / Median / High Price $151.88 / $151.88 / $151.88	Facility		$151.88	$151.88	$151.88
Cigna Facility/Professional Facility Modifier Low / Median / High Price $283.85 / $331.70 / $508.84	Facility		$283.85	$331.70	$508.84
Cigna Facility/Professional Professional Modifier Low / Median / High Price $129.68 / $303.08 / $488.59	Professional		$129.68	$303.08	$488.59
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $79.79 / $118.56 / $222.09	Facility		$79.79	$118.56	$222.09
Medica Facility/Professional Facility Modifier Low / Median / High Price $79.98 / $149.76 / $1,449.00	Facility		$79.98	$149.76	$1,449.00
Medica Facility/Professional Professional Modifier Low / Median / High Price $119.09 / $258.02 / $1,011.75	Professional		$119.09	$258.02	$1,011.75
Molina Facility/Professional Professional Modifier Low / Median / High Price $52.98 / $110.33 / $219.68	Professional		$52.98	$110.33	$219.68
Prevea360 Facility/Professional Facility Modifier Low / Median / High Price $79.79 / $116.41 / $222.09	Facility		$79.79	$116.41	$222.09
Quartz Facility/Professional Professional Modifier Low / Median / High Price $179.52 / $244.78 / $351.87	Professional		$179.52	$244.78	$351.87
Quartz Facility/Professional Facility Modifier Low / Median / High Price $119.63 / $119.63 / $380.80	Facility		$119.63	$119.63	$380.80
Quartz Facility/Professional Professional Modifier Low / Median / High Price $176.01 / $452.61 / $1,011.75	Professional		$176.01	$452.61	$1,011.75
Security Health Facility/Professional Professional Modifier Low / Median / High Price $267.86 / $267.86 / $349.51	Professional		$267.86	$267.86	$349.51
Security Health Facility/Professional Professional Modifier Low / Median / High Price $325.27 / $523.89 / $684.27	Professional		$325.27	$523.89	$684.27
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 $113.36 / $223.29 / $453.03	Professional		$113.36	$223.29	$453.03