Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $31.57 / $61.37 / $244.57	Facility		$31.57	$61.37	$244.57
Aetna Facility/Professional Professional Modifier Low / Median / High Price $31.17 / $61.11 / $173.35	Professional		$31.17	$61.11	$173.35
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 $40.00 / $72.86 / $195.26	Professional		$40.00	$72.86	$195.26
CareSource Facility/Professional Facility Modifier Low / Median / High Price $116.16 / $116.16 / $116.16	Facility		$116.16	$116.16	$116.16
Cigna Facility/Professional Facility Modifier Low / Median / High Price $172.11 / $201.13 / $308.54	Facility		$172.11	$201.13	$308.54
Cigna Facility/Professional Professional Modifier Low / Median / High Price $57.66 / $129.40 / $283.43	Professional		$57.66	$129.40	$283.43
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $31.57 / $61.37 / $130.10	Facility		$31.57	$61.37	$130.10
Medica Facility/Professional Facility Modifier Low / Median / High Price $32.06 / $67.42 / $1,449.00	Facility		$32.06	$67.42	$1,449.00
Medica Facility/Professional Professional Modifier Low / Median / High Price $67.45 / $146.30 / $478.96	Professional		$67.45	$146.30	$478.96
Molina Facility/Professional Professional Modifier Low / Median / High Price $41.03 / $85.00 / $156.20	Professional		$41.03	$85.00	$156.20
Prevea360 Facility/Professional Facility Modifier Low / Median / High Price $31.57 / $61.37 / $130.10	Facility		$31.57	$61.37	$130.10
Quartz Facility/Professional Professional Modifier Low / Median / High Price $76.27 / $132.12 / $225.96	Professional		$76.27	$132.12	$225.96
Quartz Facility/Professional Facility Modifier Low / Median / High Price $89.05 / $89.05 / $153.63	Facility		$89.05	$89.05	$153.63
Quartz Facility/Professional Professional Modifier Low / Median / High Price $70.47 / $250.22 / $478.96	Professional		$70.47	$250.22	$478.96
Security Health Facility/Professional Professional Modifier Low / Median / High Price $99.65 / $205.96 / $413.99	Professional		$99.65	$205.96	$413.99
United Facility/Professional Facility Modifier Low / Median / High Price $1,034.00 / $1,590.00 / $2,202.90	Facility		$1,034.00	$1,590.00	$2,202.90
United Facility/Professional Professional Modifier Low / Median / High Price $65.02 / $122.36 / $272.91	Professional		$65.02	$122.36	$272.91