Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $94.10 / $266.77 / $3,119.00	Facility		$94.10	$266.77	$3,119.00
Aetna Facility/Professional Professional Modifier Low / Median / High Price $76.66 / $179.96 / $722.94	Professional		$76.66	$179.96	$722.94
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 $108.67 / $258.18 / $631.57	Professional		$108.67	$258.18	$631.57
CareSource Facility/Professional Facility Modifier Low / Median / High Price $64.89 / $97.14 / $97.14	Facility		$64.89	$97.14	$97.14
CareSource Facility/Professional Professional Modifier Low / Median / High Price $120.20 / $169.91 / $262.63	Professional		$120.20	$169.91	$262.63
Cigna Facility/Professional Facility Modifier Low / Median / High Price $346.93 / $405.42 / $653.91	Facility		$346.93	$405.42	$653.91
Cigna Facility/Professional Professional Modifier Low / Median / High Price $114.05 / $238.46 / $454.31	Professional		$114.05	$238.46	$454.31
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $80.59 / $135.38 / $251.18	Facility		$80.59	$135.38	$251.18
Medica Facility/Professional Facility Modifier Low / Median / High Price $81.83 / $189.82 / $1,778.00	Facility		$81.83	$189.82	$1,778.00
Medica Facility/Professional Professional Modifier Low / Median / High Price $135.78 / $405.41 / $841.21	Professional		$135.78	$405.41	$841.21
Molina Facility/Professional Professional Modifier Low / Median / High Price $77.22 / $155.33 / $338.03	Professional		$77.22	$155.33	$338.03
Prevea360 Facility/Professional Facility Modifier Low / Median / High Price $80.59 / $135.38 / $251.18	Facility		$80.59	$135.38	$251.18
Quartz Facility/Professional Professional Modifier Low / Median / High Price $159.53 / $261.45 / $441.91	Professional		$159.53	$261.45	$441.91
Quartz Facility/Professional Facility Modifier Low / Median / High Price $562.52 / $562.52 / $562.52	Facility		$562.52	$562.52	$562.52
Quartz Facility/Professional Professional Modifier Low / Median / High Price $95.44 / $549.14 / $955.92	Professional		$95.44	$549.14	$955.92
Security Health Facility/Professional Professional Modifier Low / Median / High Price $255.80 / $409.57 / $780.26	Professional		$255.80	$409.57	$780.26
United Facility/Professional Facility Modifier Low / Median / High Price $1,034.00 / $1,423.00 / $2,202.90	Facility		$1,034.00	$1,423.00	$2,202.90
United Facility/Professional Professional Modifier Low / Median / High Price $130.07 / $422.17 / $540.65	Professional		$130.07	$422.17	$540.65