Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $96.31 / $202.84 / $478.19	Facility		$96.31	$202.84	$478.19
Aetna Facility/Professional Professional Modifier Low / Median / High Price $96.31 / $126.77 / $469.35	Professional		$96.31	$126.77	$469.35
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 $122.00 / $222.25 / $580.96	Professional		$122.00	$222.25	$580.96
CareSource Facility/Professional Facility Modifier Low / Median / High Price $92.76 / $115.28 / $173.74	Facility		$92.76	$115.28	$173.74
CareSource Facility/Professional Professional Modifier Low / Median / High Price $117.96 / $123.86 / $164.70	Professional		$117.96	$123.86	$164.70
Cigna Facility/Professional Facility Modifier Low / Median / High Price $341.52 / $399.10 / $612.23	Facility		$341.52	$399.10	$612.23
Cigna Facility/Professional Professional Modifier Low / Median / High Price $156.00 / $351.81 / $592.54	Professional		$156.00	$351.81	$592.54
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $96.72 / $151.86 / $265.12	Facility		$96.72	$151.86	$265.12
Medica Facility/Professional Facility Modifier Low / Median / High Price $102.48 / $190.16 / $1,449.00	Facility		$102.48	$190.16	$1,449.00
Medica Facility/Professional Professional Modifier Low / Median / High Price $148.69 / $326.82 / $966.32	Professional		$148.69	$326.82	$966.32
Molina Facility/Professional Professional Modifier Low / Median / High Price $78.44 / $140.26 / $326.70	Professional		$78.44	$140.26	$326.70
Prevea360 Facility/Professional Facility Modifier Low / Median / High Price $96.72 / $151.86 / $265.12	Facility		$96.72	$151.86	$265.12
Quartz Facility/Professional Professional Modifier Low / Median / High Price $219.50 / $306.07 / $437.31	Professional		$219.50	$306.07	$437.31
Quartz Facility/Professional Facility Modifier Low / Median / High Price $128.28 / $128.28 / $461.60	Facility		$128.28	$128.28	$461.60
Quartz Facility/Professional Professional Modifier Low / Median / High Price $207.69 / $548.91 / $966.32	Professional		$207.69	$548.91	$966.32
Security Health Facility/Professional Professional Modifier Low / Median / High Price $302.27 / $628.32 / $829.85	Professional		$302.27	$628.32	$829.85
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 $143.83 / $263.91 / $571.94	Professional		$143.83	$263.91	$571.94