Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $73.29 / $104.09 / $396.35	Facility		$73.29	$104.09	$396.35
Aetna Facility/Professional Professional Modifier Low / Median / High Price $73.29 / $104.09 / $404.43	Professional		$73.29	$104.09	$404.43
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 $92.84 / $169.12 / $432.75	Professional		$92.84	$169.12	$432.75
CareSource Facility/Professional Facility Modifier Low / Median / High Price $153.90 / $153.90 / $153.90	Facility		$153.90	$153.90	$153.90
Cigna Facility/Professional Facility Modifier Low / Median / High Price $281.14 / $328.55 / $504.00	Facility		$281.14	$328.55	$504.00
Cigna Facility/Professional Professional Modifier Low / Median / High Price $114.72 / $287.73 / $486.41	Professional		$114.72	$287.73	$486.41
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $68.51 / $108.35 / $220.44	Facility		$68.51	$108.35	$220.44
Medica Facility/Professional Facility Modifier Low / Median / High Price $72.48 / $127.95 / $1,449.00	Facility		$72.48	$127.95	$1,449.00
Medica Facility/Professional Professional Modifier Low / Median / High Price $110.43 / $233.46 / $795.04	Professional		$110.43	$233.46	$795.04
Molina Facility/Professional Professional Modifier Low / Median / High Price $58.91 / $101.24 / $250.69	Professional		$58.91	$101.24	$250.69
Prevea360 Facility/Professional Facility Modifier Low / Median / High Price $68.51 / $108.35 / $220.44	Facility		$68.51	$108.35	$220.44
Quartz Facility/Professional Professional Modifier Low / Median / High Price $176.92 / $251.89 / $370.99	Professional		$176.92	$251.89	$370.99
Quartz Facility/Professional Facility Modifier Low / Median / High Price $118.97 / $118.97 / $351.19	Facility		$118.97	$118.97	$351.19
Quartz Facility/Professional Professional Modifier Low / Median / High Price $156.09 / $450.59 / $795.04	Professional		$156.09	$450.59	$795.04
Security Health Facility/Professional Professional Modifier Low / Median / High Price $243.37 / $243.37 / $339.56	Professional		$243.37	$243.37	$339.56
Security Health Facility/Professional Professional Modifier Low / Median / High Price $253.84 / $475.27 / $681.16	Professional		$253.84	$475.27	$681.16
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 $106.74 / $184.12 / $457.36	Professional		$106.74	$184.12	$457.36