Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $89.89 / $121.03 / $464.52	Facility		$89.89	$121.03	$464.52
Aetna Facility/Professional Professional Modifier Low / Median / High Price $89.89 / $121.03 / $490.28	Professional		$89.89	$121.03	$490.28
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 $113.39 / $205.99 / $552.35	Professional		$113.39	$205.99	$552.35
CareSource Facility/Professional Facility Modifier Low / Median / High Price $194.59 / $194.59 / $194.59	Facility		$194.59	$194.59	$194.59
Cigna Facility/Professional Facility Modifier Low / Median / High Price $330.71 / $386.46 / $592.84	Facility		$330.71	$386.46	$592.84
Cigna Facility/Professional Professional Modifier Low / Median / High Price $139.03 / $335.70 / $569.28	Professional		$139.03	$335.70	$569.28
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $89.89 / $130.61 / $256.58	Facility		$89.89	$130.61	$256.58
Medica Facility/Professional Facility Modifier Low / Median / High Price $89.89 / $149.41 / $1,449.00	Facility		$89.89	$149.41	$1,449.00
Medica Facility/Professional Professional Modifier Low / Median / High Price $126.67 / $263.45 / $927.52	Professional		$126.67	$263.45	$927.52
Molina Facility/Professional Professional Modifier Low / Median / High Price $58.91 / $110.23 / $250.69	Professional		$58.91	$110.23	$250.69
Prevea360 Facility/Professional Facility Modifier Low / Median / High Price $89.89 / $130.50 / $256.58	Facility		$89.89	$130.50	$256.58
Quartz Facility/Professional Professional Modifier Low / Median / High Price $208.44 / $297.72 / $433.94	Professional		$208.44	$297.72	$433.94
Quartz Facility/Professional Facility Modifier Low / Median / High Price $151.54 / $151.54 / $437.60	Facility		$151.54	$151.54	$437.60
Quartz Facility/Professional Professional Modifier Low / Median / High Price $192.52 / $527.36 / $927.52	Professional		$192.52	$527.36	$927.52
Security Health Facility/Professional Professional Modifier Low / Median / High Price $296.27 / $296.27 / $393.56	Professional		$296.27	$296.27	$393.56
Security Health Facility/Professional Professional Modifier Low / Median / High Price $335.37 / $587.03 / $797.28	Professional		$335.37	$587.03	$797.28
United Facility/Professional Facility Modifier Low / Median / High Price $875.66 / $1,297.00 / $2,202.90	Facility		$875.66	$1,297.00	$2,202.90
United Facility/Professional Professional Modifier Low / Median / High Price $126.67 / $235.32 / $533.66	Professional		$126.67	$235.32	$533.66