Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $195.08 / $489.10 / $2,964.00	Facility		$195.08	$489.10	$2,964.00
Aetna Facility/Professional Professional Modifier Low / Median / High Price $127.34 / $187.58 / $722.10	Professional		$127.34	$187.58	$722.10
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 $158.94 / $388.92 / $964.31	Professional		$158.94	$388.92	$964.31
CareSource Facility/Professional Facility Modifier Low / Median / High Price $127.54 / $192.84 / $192.84	Facility		$127.54	$192.84	$192.84
CareSource Facility/Professional Professional Modifier Low / Median / High Price $228.39 / $313.66 / $353.02	Professional		$228.39	$313.66	$353.02
Cigna Facility/Professional Facility Modifier Low / Median / High Price $426.23 / $498.08 / $803.39	Facility		$426.23	$498.08	$803.39
Cigna Facility/Professional Professional Modifier Low / Median / High Price $252.25 / $442.53 / $665.38	Professional		$252.25	$442.53	$665.38
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $134.16 / $209.38 / $318.80	Facility		$134.16	$209.38	$318.80
Medica Facility/Professional Facility Modifier Low / Median / High Price $147.00 / $277.49 / $4,250.74	Facility		$147.00	$277.49	$4,250.74
Medica Facility/Professional Professional Modifier Low / Median / High Price $191.98 / $539.71 / $997.28	Professional		$191.98	$539.71	$997.28
Molina Facility/Professional Professional Modifier Low / Median / High Price $77.30 / $221.44 / $460.21	Professional		$77.30	$221.44	$460.21
Prevea360 Facility/Professional Facility Modifier Low / Median / High Price $134.16 / $209.38 / $318.80	Facility		$134.16	$209.38	$318.80
Quartz Facility/Professional Professional Modifier Low / Median / High Price $309.89 / $415.83 / $580.51	Professional		$309.89	$415.83	$580.51
Quartz Facility/Professional Facility Modifier Low / Median / High Price $627.76 / $627.76 / $627.76	Facility		$627.76	$627.76	$627.76
Quartz Facility/Professional Professional Modifier Low / Median / High Price $256.58 / $686.66 / $1,213.35	Professional		$256.58	$686.66	$1,213.35
Security Health Facility/Professional Professional Modifier Low / Median / High Price $685.07 / $923.88 / $1,131.75	Professional		$685.07	$923.88	$1,131.75
United Facility/Professional Facility Modifier Low / Median / High Price $2,257.00 / $3,088.30 / $4,295.00	Facility		$2,257.00	$3,088.30	$4,295.00
United Facility/Professional Professional Modifier Low / Median / High Price $189.46 / $484.74 / $772.42	Professional		$189.46	$484.74	$772.42