Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $98.80 / $158.07 / $612.53	Facility		$98.80	$158.07	$612.53
Aetna Facility/Professional Professional Modifier Low / Median / High Price $98.80 / $160.52 / $536.84	Professional		$98.80	$160.52	$536.84
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 $125.17 / $228.01 / $578.53	Professional		$125.17	$228.01	$578.53
CareSource Facility/Professional Facility Modifier Low / Median / High Price $281.95 / $281.95 / $281.95	Facility		$281.95	$281.95	$281.95
Cigna Facility/Professional Facility Modifier Low / Median / High Price $437.04 / $510.72 / $783.46	Facility		$437.04	$510.72	$783.46
Cigna Facility/Professional Professional Modifier Low / Median / High Price $163.59 / $392.63 / $750.23	Professional		$163.59	$392.63	$750.23
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $99.77 / $164.18 / $335.11	Facility		$99.77	$164.18	$335.11
Medica Facility/Professional Facility Modifier Low / Median / High Price $104.89 / $206.48 / $1,449.00	Facility		$104.89	$206.48	$1,449.00
Medica Facility/Professional Professional Modifier Low / Median / High Price $166.98 / $368.26 / $1,217.52	Professional		$166.98	$368.26	$1,217.52
Molina Facility/Professional Professional Modifier Low / Median / High Price $77.22 / $148.14 / $338.03	Professional		$77.22	$148.14	$338.03
Prevea360 Facility/Professional Facility Modifier Low / Median / High Price $101.23 / $164.18 / $335.11	Facility		$101.23	$164.18	$335.11
Quartz Facility/Professional Professional Modifier Low / Median / High Price $239.49 / $369.03 / $568.85	Professional		$239.49	$369.03	$568.85
Quartz Facility/Professional Facility Modifier Low / Median / High Price $221.99 / $221.99 / $482.12	Facility		$221.99	$221.99	$482.12
Quartz Facility/Professional Professional Modifier Low / Median / High Price $211.65 / $694.98 / $1,217.52	Professional		$211.65	$694.98	$1,217.52
Security Health Facility/Professional Professional Modifier Low / Median / High Price $325.36 / $325.36 / $510.99	Professional		$325.36	$325.36	$510.99
Security Health Facility/Professional Professional Modifier Low / Median / High Price $422.80 / $645.40 / $1,050.68	Professional		$422.80	$645.40	$1,050.68
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 $162.76 / $316.33 / $685.96	Professional		$162.76	$316.33	$685.96