Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $50.42 / $193.34 / $517.88	Facility		$50.42	$193.34	$517.88
Aetna Facility/Professional Professional Modifier Low / Median / High Price $46.36 / $85.85 / $346.00	Professional		$46.36	$85.85	$346.00
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 $63.87 / $116.36 / $291.75	Professional		$63.87	$116.36	$291.75
CareSource Facility/Professional Facility Modifier Low / Median / High Price $163.83 / $163.83 / $163.83	Facility		$163.83	$163.83	$163.83
Cigna Facility/Professional Facility Modifier Low / Median / High Price $245.10 / $286.42 / $439.38	Facility		$245.10	$286.42	$439.38
Cigna Facility/Professional Professional Modifier Low / Median / High Price $80.01 / $191.57 / $389.28	Professional		$80.01	$191.57	$389.28
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $50.42 / $87.60 / $193.34	Facility		$50.42	$87.60	$193.34
Medica Facility/Professional Facility Modifier Low / Median / High Price $51.77 / $103.57 / $1,368.00	Facility		$51.77	$103.57	$1,368.00
Medica Facility/Professional Professional Modifier Low / Median / High Price $86.98 / $197.10 / $675.60	Professional		$86.98	$197.10	$675.60
Molina Facility/Professional Professional Modifier Low / Median / High Price $58.91 / $101.24 / $231.99	Professional		$58.91	$101.24	$231.99
Prevea360 Facility/Professional Facility Modifier Low / Median / High Price $50.42 / $87.60 / $193.34	Facility		$50.42	$87.60	$193.34
Quartz Facility/Professional Professional Modifier Low / Median / High Price $122.79 / $192.35 / $318.14	Professional		$122.79	$192.35	$318.14
Quartz Facility/Professional Facility Modifier Low / Median / High Price $133.60 / $133.60 / $246.00	Facility		$133.60	$133.60	$246.00
Quartz Facility/Professional Professional Modifier Low / Median / High Price $110.96 / $387.41 / $675.60	Professional		$110.96	$387.41	$675.60
Security Health Facility/Professional Professional Modifier Low / Median / High Price $161.51 / $332.11 / $585.72	Professional		$161.51	$332.11	$585.72
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 $86.98 / $157.76 / $370.01	Professional		$86.98	$157.76	$370.01