Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $76.58 / $243.52 / $1,894.00	Facility		$76.58	$243.52	$1,894.00
Aetna Facility/Professional Professional Modifier Low / Median / High Price $76.58 / $117.47 / $430.54	Professional		$76.58	$117.47	$430.54
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 $94.99 / $176.73 / $449.95	Professional		$94.99	$176.73	$449.95
CareSource Facility/Professional Facility Modifier Low / Median / High Price $180.69 / $180.69 / $180.69	Facility		$180.69	$180.69	$180.69
Cigna Facility/Professional Facility Modifier Low / Median / High Price $315.39 / $368.56 / $565.38	Facility		$315.39	$368.56	$565.38
Cigna Facility/Professional Professional Modifier Low / Median / High Price $123.31 / $293.70 / $572.46	Professional		$123.31	$293.70	$572.46
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $78.98 / $123.57 / $244.11	Facility		$78.98	$123.57	$244.11
Medica Facility/Professional Facility Modifier Low / Median / High Price $79.70 / $154.82 / $1,449.00	Facility		$79.70	$154.82	$1,449.00
Medica Facility/Professional Professional Modifier Low / Median / High Price $115.57 / $225.04 / $621.84	Professional		$115.57	$225.04	$621.84
Molina Facility/Professional Professional Modifier Low / Median / High Price $58.91 / $108.23 / $250.69	Professional		$58.91	$108.23	$250.69
Prevea360 Facility/Professional Facility Modifier Low / Median / High Price $78.98 / $123.57 / $244.11	Facility		$78.98	$123.57	$244.11
Quartz Facility/Professional Professional Modifier Low / Median / High Price $182.26 / $271.41 / $400.22	Professional		$182.26	$271.41	$400.22
Quartz Facility/Professional Facility Modifier Low / Median / High Price $165.49 / $165.49 / $361.81	Facility		$165.49	$165.49	$361.81
Quartz Facility/Professional Professional Modifier Low / Median / High Price $159.69 / $500.27 / $873.20	Professional		$159.69	$500.27	$873.20
Security Health Facility/Professional Professional Modifier Low / Median / High Price $270.22 / $500.58 / $756.26	Professional		$270.22	$500.58	$756.26
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 $114.36 / $224.50 / $461.99	Professional		$114.36	$224.50	$461.99