Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $78.34 / $119.18 / $458.90	Facility		$78.34	$119.18	$458.90
Aetna Facility/Professional Professional Modifier Low / Median / High Price $78.34 / $119.18 / $431.92	Professional		$78.34	$119.18	$431.92
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 $99.23 / $180.78 / $462.83	Professional		$99.23	$180.78	$462.83
CareSource Facility/Professional Facility Modifier Low / Median / High Price $181.67 / $181.67 / $181.67	Facility		$181.67	$181.67	$181.67
Cigna Facility/Professional Facility Modifier Low / Median / High Price $324.39 / $379.09 / $581.54	Facility		$324.39	$379.09	$581.54
Cigna Facility/Professional Professional Modifier Low / Median / High Price $126.89 / $314.45 / $560.73	Professional		$126.89	$314.45	$560.73
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $78.34 / $123.11 / $252.66	Facility		$78.34	$123.11	$252.66
Medica Facility/Professional Facility Modifier Low / Median / High Price $78.34 / $146.47 / $1,449.00	Facility		$78.34	$146.47	$1,449.00
Medica Facility/Professional Professional Modifier Low / Median / High Price $130.54 / $271.41 / $914.72	Professional		$130.54	$271.41	$914.72
Molina Facility/Professional Professional Modifier Low / Median / High Price $58.91 / $110.23 / $250.69	Professional		$58.91	$110.23	$250.69
Prevea360 Facility/Professional Facility Modifier Low / Median / High Price $78.34 / $123.11 / $252.66	Facility		$78.34	$123.11	$252.66
Quartz Facility/Professional Professional Modifier Low / Median / High Price $189.91 / $282.76 / $429.44	Professional		$189.91	$282.76	$429.44
Quartz Facility/Professional Facility Modifier Low / Median / High Price $146.22 / $146.22 / $380.72	Facility		$146.22	$146.22	$380.72
Quartz Facility/Professional Professional Modifier Low / Median / High Price $171.96 / $519.44 / $914.72	Professional		$171.96	$519.44	$914.72
Security Health Facility/Professional Professional Modifier Low / Median / High Price $260.27 / $260.27 / $387.76	Professional		$260.27	$260.27	$387.76
Security Health Facility/Professional Professional Modifier Low / Median / High Price $332.56 / $507.91 / $785.31	Professional		$332.56	$507.91	$785.31
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 $127.79 / $249.00 / $525.71	Professional		$127.79	$249.00	$525.71