Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $130.86 / $492.39 / $3,119.00	Facility		$130.86	$492.39	$3,119.00
Aetna Facility/Professional Professional Modifier Low / Median / High Price $128.06 / $240.01 / $1,016.50	Professional		$128.06	$240.01	$1,016.50
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $1,314.00 / $2,550.00 / $4,471.00	Facility		$1,314.00	$2,550.00	$4,471.00
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $165.77 / $301.99 / $770.91	Professional		$165.77	$301.99	$770.91
CareSource Facility/Professional Facility Modifier Low / Median / High Price $512.28 / $512.28 / $512.28	Facility		$512.28	$512.28	$512.28
Cigna Facility/Professional Facility Modifier Low / Median / High Price $649.71 / $759.23 / $1,164.69	Facility		$649.71	$759.23	$1,164.69
Cigna Facility/Professional Professional Modifier Low / Median / High Price $233.18 / $539.19 / $1,111.01	Professional		$233.18	$539.19	$1,111.01
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $130.86 / $262.61 / $493.81	Facility		$130.86	$262.61	$493.81
Medica Facility/Professional Facility Modifier Low / Median / High Price $133.86 / $280.81 / $3,026.00	Facility		$133.86	$280.81	$3,026.00
Medica Facility/Professional Professional Modifier Low / Median / High Price $268.85 / $569.07 / $1,880.28	Professional		$268.85	$569.07	$1,880.28
Molina Facility/Professional Professional Modifier Low / Median / High Price $123.44 / $236.55 / $515.75	Professional		$123.44	$236.55	$515.75
Prevea360 Facility/Professional Facility Modifier Low / Median / High Price $130.86 / $262.61 / $493.81	Facility		$130.86	$262.61	$493.81
Quartz Facility/Professional Professional Modifier Low / Median / High Price $306.61 / $511.92 / $799.31	Professional		$306.61	$511.92	$799.31
Quartz Facility/Professional Facility Modifier Low / Median / High Price $325.68 / $325.68 / $627.36	Facility		$325.68	$325.68	$627.36
Quartz Facility/Professional Professional Modifier Low / Median / High Price $293.64 / $1,000.56 / $1,880.28	Professional		$293.64	$1,000.56	$1,880.28
Security Health Facility/Professional Professional Modifier Low / Median / High Price $413.06 / $858.14 / $1,555.96	Professional		$413.06	$858.14	$1,555.96
United Facility/Professional Facility Modifier Low / Median / High Price $1,944.00 / $3,088.30 / $4,985.00	Facility		$1,944.00	$3,088.30	$4,985.00
United Facility/Professional Professional Modifier Low / Median / High Price $262.37 / $480.68 / $1,107.09	Professional		$262.37	$480.68	$1,107.09