Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $95.85 / $284.60 / $1,894.00	Facility		$95.85	$284.60	$1,894.00
Aetna Facility/Professional Professional Modifier Low / Median / High Price $93.60 / $136.53 / $604.00	Professional		$93.60	$136.53	$604.00
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 $121.43 / $221.20 / $561.00	Professional		$121.43	$221.20	$561.00
CareSource Facility/Professional Facility Modifier Low / Median / High Price $218.43 / $218.43 / $218.43	Facility		$218.43	$218.43	$218.43
Cigna Facility/Professional Facility Modifier Low / Median / High Price $361.35 / $422.27 / $647.77	Facility		$361.35	$422.27	$647.77
Cigna Facility/Professional Professional Modifier Low / Median / High Price $148.85 / $355.57 / $622.53	Professional		$148.85	$355.57	$622.53
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $95.85 / $143.78 / $283.35	Facility		$95.85	$143.78	$283.35
Medica Facility/Professional Facility Modifier Low / Median / High Price $98.17 / $169.75 / $1,449.00	Facility		$98.17	$169.75	$1,449.00
Medica Facility/Professional Professional Modifier Low / Median / High Price $145.88 / $305.69 / $1,012.88	Professional		$145.88	$305.69	$1,012.88
Molina Facility/Professional Professional Modifier Low / Median / High Price $77.22 / $135.30 / $338.03	Professional		$77.22	$135.30	$338.03
Prevea360 Facility/Professional Facility Modifier Low / Median / High Price $95.85 / $143.78 / $283.35	Facility		$95.85	$143.78	$283.35
Quartz Facility/Professional Professional Modifier Low / Median / High Price $226.80 / $323.95 / $472.16	Professional		$226.80	$323.95	$472.16
Quartz Facility/Professional Facility Modifier Low / Median / High Price $168.16 / $168.16 / $463.04	Facility		$168.16	$168.16	$463.04
Quartz Facility/Professional Professional Modifier Low / Median / High Price $204.18 / $576.67 / $1,012.88	Professional		$204.18	$576.67	$1,012.88
Security Health Facility/Professional Professional Modifier Low / Median / High Price $301.67 / $622.58 / $871.83	Professional		$301.67	$622.58	$871.83
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 $143.66 / $263.36 / $583.90	Professional		$143.66	$263.36	$583.90