Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $42.83 / $62.58 / $239.40	Facility		$42.83	$62.58	$239.40
Aetna Facility/Professional Professional Modifier Low / Median / High Price $42.83 / $63.66 / $224.12	Professional		$42.83	$63.66	$224.12
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 $54.25 / $98.83 / $263.51	Professional		$54.25	$98.83	$263.51
CareSource Facility/Professional Facility Modifier Low / Median / High Price $92.32 / $92.32 / $92.32	Facility		$92.32	$92.32	$92.32
Cigna Facility/Professional Facility Modifier Low / Median / High Price $173.02 / $202.18 / $310.14	Facility		$173.02	$202.18	$310.14
Cigna Facility/Professional Professional Modifier Low / Median / High Price $67.51 / $167.54 / $298.45	Professional		$67.51	$167.54	$298.45
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $39.89 / $64.25 / $132.66	Facility		$39.89	$64.25	$132.66
Medica Facility/Professional Facility Modifier Low / Median / High Price $42.83 / $76.42 / $1,449.00	Facility		$42.83	$76.42	$1,449.00
Medica Facility/Professional Professional Modifier Low / Median / High Price $69.84 / $147.72 / $486.56	Professional		$69.84	$147.72	$486.56
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 $39.89 / $64.25 / $132.66	Facility		$39.89	$64.25	$132.66
Quartz Facility/Professional Professional Modifier Low / Median / High Price $102.19 / $151.01 / $222.59	Professional		$102.19	$151.01	$222.59
Quartz Facility/Professional Facility Modifier Low / Median / High Price $73.11 / $73.11 / $202.83	Facility		$73.11	$73.11	$202.83
Quartz Facility/Professional Professional Modifier Low / Median / High Price $93.84 / $276.48 / $486.56	Professional		$93.84	$276.48	$486.56
Security Health Facility/Professional Professional Modifier Low / Median / High Price $141.34 / $141.34 / $205.08	Professional		$141.34	$141.34	$205.08
Security Health Facility/Professional Professional Modifier Low / Median / High Price $133.75 / $279.27 / $418.00	Professional		$133.75	$279.27	$418.00
United Facility/Professional Facility Modifier Low / Median / High Price $785.00 / $1,297.00 / $2,202.90	Facility		$785.00	$1,297.00	$2,202.90
United Facility/Professional Professional Modifier Low / Median / High Price $66.88 / $128.71 / $264.41	Professional		$66.88	$128.71	$264.41