Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $173.39 / $369.23 / $1,129.74	Facility		$173.39	$369.23	$1,129.74
Aetna Facility/Professional Professional Modifier Low / Median / High Price $173.39 / $290.24 / $941.12	Professional		$173.39	$290.24	$941.12
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 $219.65 / $400.13 / $1,060.32	Professional		$219.65	$400.13	$1,060.32
CareSource Facility/Professional Facility Modifier Low / Median / High Price $334.36 / $334.36 / $334.36	Facility		$334.36	$334.36	$334.36
Cigna Facility/Professional Facility Modifier Low / Median / High Price $805.60 / $941.41 / $1,444.15	Facility		$805.60	$941.41	$1,444.15
Cigna Facility/Professional Professional Modifier Low / Median / High Price $287.83 / $711.93 / $1,378.49	Professional		$287.83	$711.93	$1,378.49
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $174.10 / $302.02 / $615.30	Facility		$174.10	$302.02	$615.30
Medica Facility/Professional Facility Modifier Low / Median / High Price $183.38 / $363.10 / $1,449.00	Facility		$183.38	$363.10	$1,449.00
Medica Facility/Professional Professional Modifier Low / Median / High Price $283.58 / $618.98 / $2,232.23	Professional		$283.58	$618.98	$2,232.23
Molina Facility/Professional Professional Modifier Low / Median / High Price $170.83 / $328.96 / $706.33	Professional		$170.83	$328.96	$706.33
Prevea360 Facility/Professional Facility Modifier Low / Median / High Price $177.90 / $302.02 / $615.30	Facility		$177.90	$302.02	$615.30
Quartz Facility/Professional Professional Modifier Low / Median / High Price $421.01 / $652.63 / $1,047.75	Professional		$421.01	$652.63	$1,047.75
Quartz Facility/Professional Facility Modifier Low / Median / High Price $292.86 / $292.86 / $844.32	Facility		$292.86	$292.86	$844.32
Quartz Facility/Professional Professional Modifier Low / Median / High Price $371.54 / $1,276.97 / $2,232.23	Professional		$371.54	$1,276.97	$2,232.23
Security Health Facility/Professional Professional Modifier Low / Median / High Price $568.72 / $568.72 / $935.55	Professional		$568.72	$568.72	$935.55
Security Health Facility/Professional Professional Modifier Low / Median / High Price $699.24 / $1,132.98 / $1,930.53	Professional		$699.24	$1,132.98	$1,930.53
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 $284.56 / $531.33 / $1,228.38	Professional		$284.56	$531.33	$1,228.38