Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $132.34 / $220.73 / $860.43	Facility		$132.34	$220.73	$860.43
Aetna Facility/Professional Professional Modifier Low / Median / High Price $132.34 / $220.73 / $715.68	Professional		$132.34	$220.73	$715.68
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 $167.64 / $305.39 / $808.11	Professional		$167.64	$305.39	$808.11
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 $612.76 / $716.06 / $1,098.46	Facility		$612.76	$716.06	$1,098.46
Cigna Facility/Professional Professional Modifier Low / Median / High Price $220.27 / $544.45 / $977.17	Professional		$220.27	$544.45	$977.17
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $132.34 / $220.73 / $467.95	Facility		$132.34	$220.73	$467.95
Medica Facility/Professional Facility Modifier Low / Median / High Price $139.41 / $274.39 / $1,449.00	Facility		$139.41	$274.39	$1,449.00
Medica Facility/Professional Professional Modifier Low / Median / High Price $227.04 / $478.30 / $1,697.92	Professional		$227.04	$478.30	$1,697.92
Molina Facility/Professional Professional Modifier Low / Median / High Price $134.13 / $236.55 / $551.40	Professional		$134.13	$236.55	$551.40
Prevea360 Facility/Professional Facility Modifier Low / Median / High Price $132.93 / $220.73 / $467.95	Facility		$132.93	$220.73	$467.95
Quartz Facility/Professional Professional Modifier Low / Median / High Price $322.62 / $500.11 / $798.18	Professional		$322.62	$500.11	$798.18
Quartz Facility/Professional Facility Modifier Low / Median / High Price $292.86 / $292.86 / $645.64	Facility		$292.86	$292.86	$645.64
Quartz Facility/Professional Professional Modifier Low / Median / High Price $287.32 / $971.64 / $1,697.92	Professional		$287.32	$971.64	$1,697.92
Security Health Facility/Professional Professional Modifier Low / Median / High Price $433.45 / $433.45 / $710.78	Professional		$433.45	$433.45	$710.78
Security Health Facility/Professional Professional Modifier Low / Median / High Price $421.54 / $866.44 / $1,468.96	Professional		$421.54	$866.44	$1,468.96
United Facility/Professional Facility Modifier Low / Median / High Price $1,034.00 / $1,423.00 / $2,202.90	Facility		$1,034.00	$1,423.00	$2,202.90
United Facility/Professional Professional Modifier Low / Median / High Price $214.57 / $381.62 / $927.94	Professional		$214.57	$381.62	$927.94