Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $65.80 / $140.31 / $556.16	Facility		$65.80	$140.31	$556.16
Aetna Facility/Professional Professional Modifier Low / Median / High Price $65.80 / $108.31 / $489.25	Professional		$65.80	$108.31	$489.25
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 $83.35 / $151.84 / $385.82	Professional		$83.35	$151.84	$385.82
CareSource Facility/Professional Facility Modifier Low / Median / High Price $168.77 / $168.77 / $168.77	Facility		$168.77	$168.77	$168.77
Cigna Facility/Professional Facility Modifier Low / Median / High Price $262.23 / $306.43 / $470.07	Facility		$262.23	$306.43	$470.07
Cigna Facility/Professional Professional Modifier Low / Median / High Price $104.33 / $247.75 / $449.98	Professional		$104.33	$247.75	$449.98
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $65.80 / $101.43 / $205.69	Facility		$65.80	$101.43	$205.69
Medica Facility/Professional Facility Modifier Low / Median / High Price $69.09 / $128.60 / $1,449.00	Facility		$69.09	$128.60	$1,449.00
Medica Facility/Professional Professional Modifier Low / Median / High Price $102.31 / $208.58 / $730.00	Professional		$102.31	$208.58	$730.00
Molina Facility/Professional Professional Modifier Low / Median / High Price $58.91 / $101.24 / $235.87	Professional		$58.91	$101.24	$235.87
Prevea360 Facility/Professional Facility Modifier Low / Median / High Price $65.80 / $99.78 / $205.69	Facility		$65.80	$99.78	$205.69
Quartz Facility/Professional Professional Modifier Low / Median / High Price $158.62 / $230.34 / $339.51	Professional		$158.62	$230.34	$339.51
Quartz Facility/Professional Facility Modifier Low / Median / High Price $132.26 / $132.26 / $320.16	Facility		$132.26	$132.26	$320.16
Quartz Facility/Professional Professional Modifier Low / Median / High Price $141.28 / $416.84 / $730.00	Professional		$141.28	$416.84	$730.00
Security Health Facility/Professional Professional Modifier Low / Median / High Price $209.09 / $430.80 / $630.19	Professional		$209.09	$430.80	$630.19
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 $99.50 / $185.40 / $411.55	Professional		$99.50	$185.40	$411.55