Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $56.98 / $121.25 / $623.26	Facility		$56.98	$121.25	$623.26
Aetna Facility/Professional Professional Modifier Low / Median / High Price $56.98 / $90.43 / $390.00	Professional		$56.98	$90.43	$390.00
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 $72.18 / $131.47 / $331.50	Professional		$72.18	$131.47	$331.50
CareSource Facility/Professional Facility Modifier Low / Median / High Price $55.56 / $70.03 / $137.01	Facility		$55.56	$70.03	$137.01
CareSource Facility/Professional Professional Modifier Low / Median / High Price $74.73 / $78.48 / $103.95	Professional		$74.73	$78.48	$103.95
Cigna Facility/Professional Facility Modifier Low / Median / High Price $217.17 / $253.78 / $389.31	Facility		$217.17	$253.78	$389.31
Cigna Facility/Professional Professional Modifier Low / Median / High Price $94.31 / $213.57 / $373.08	Professional		$94.31	$213.57	$373.08
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $58.21 / $91.04 / $170.26	Facility		$58.21	$91.04	$170.26
Medica Facility/Professional Facility Modifier Low / Median / High Price $59.77 / $113.55 / $1,449.00	Facility		$59.77	$113.55	$1,449.00
Medica Facility/Professional Professional Modifier Low / Median / High Price $89.48 / $198.02 / $605.52	Professional		$89.48	$198.02	$605.52
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 $58.21 / $91.04 / $170.26	Facility		$58.21	$91.04	$170.26
Quartz Facility/Professional Professional Modifier Low / Median / High Price $135.00 / $192.83 / $281.05	Professional		$135.00	$192.83	$281.05
Quartz Facility/Professional Facility Modifier Low / Median / High Price $104.34 / $104.34 / $275.80	Facility		$104.34	$104.34	$275.80
Quartz Facility/Professional Professional Modifier Low / Median / High Price $122.31 / $345.60 / $605.52	Professional		$122.31	$345.60	$605.52
Security Health Facility/Professional Professional Modifier Low / Median / High Price $180.69 / $372.98 / $522.50	Professional		$180.69	$372.98	$522.50
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 $85.88 / $158.80 / $346.53	Professional		$85.88	$158.80	$346.53