Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $27.56 / $42.63 / $163.77	Facility		$27.56	$42.63	$163.77
Aetna Facility/Professional Professional Modifier Low / Median / High Price $26.82 / $42.63 / $151.74	Professional		$26.82	$42.63	$151.74
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 $34.90 / $63.60 / $163.22	Professional		$34.90	$63.60	$163.22
CareSource Facility/Professional Facility Modifier Low / Median / High Price $62.55 / $62.55 / $62.55	Facility		$62.55	$62.55	$62.55
Cigna Facility/Professional Facility Modifier Low / Median / High Price $117.15 / $136.88 / $210.00	Facility		$117.15	$136.88	$210.00
Cigna Facility/Professional Professional Modifier Low / Median / High Price $46.00 / $107.84 / $201.65	Professional		$46.00	$107.84	$201.65
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $27.56 / $43.82 / $90.73	Facility		$27.56	$43.82	$90.73
Medica Facility/Professional Facility Modifier Low / Median / High Price $27.56 / $51.82 / $1,449.00	Facility		$27.56	$51.82	$1,449.00
Medica Facility/Professional Professional Modifier Low / Median / High Price $49.83 / $109.30 / $327.68	Professional		$49.83	$109.30	$327.68
Molina Facility/Professional Professional Modifier Low / Median / High Price $40.93 / $74.59 / $151.88	Professional		$40.93	$74.59	$151.88
Prevea360 Facility/Professional Facility Modifier Low / Median / High Price $27.56 / $43.49 / $90.73	Facility		$27.56	$43.49	$90.73
Quartz Facility/Professional Professional Modifier Low / Median / High Price $63.30 / $96.27 / $148.38	Professional		$63.30	$96.27	$148.38
Quartz Facility/Professional Facility Modifier Low / Median / High Price $47.20 / $47.20 / $125.66	Facility		$47.20	$47.20	$125.66
Quartz Facility/Professional Professional Modifier Low / Median / High Price $61.77 / $186.80 / $327.68	Professional		$61.77	$186.80	$327.68
Security Health Facility/Professional Professional Modifier Low / Median / High Price $91.80 / $91.80 / $138.77	Professional		$91.80	$91.80	$138.77
Security Health Facility/Professional Professional Modifier Low / Median / High Price $86.11 / $180.51 / $282.38	Professional		$86.11	$180.51	$282.38
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 $49.56 / $87.22 / $192.54	Professional		$49.56	$87.22	$192.54