Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $98.87 / $334.19 / $1,894.00	Facility		$98.87	$334.19	$1,894.00
Aetna Facility/Professional Professional Modifier Low / Median / High Price $98.87 / $184.34 / $673.38	Professional		$98.87	$184.34	$673.38
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 $158.86 / $379.97 / $928.17	Professional		$158.86	$379.97	$928.17
Cigna Facility/Professional Facility Modifier Low / Median / High Price $460.47 / $538.10 / $867.93	Facility		$460.47	$538.10	$867.93
Cigna Facility/Professional Professional Modifier Low / Median / High Price $166.67 / $367.54 / $709.34	Professional		$166.67	$367.54	$709.34
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $91.67 / $170.67 / $333.57	Facility		$91.67	$170.67	$333.57
Medica Facility/Professional Facility Modifier Low / Median / High Price $94.50 / $256.56 / $1,778.00	Facility		$94.50	$256.56	$1,778.00
Medica Facility/Professional Professional Modifier Low / Median / High Price $185.92 / $551.77 / $1,172.64	Professional		$185.92	$551.77	$1,172.64
Molina Facility/Professional Professional Modifier Low / Median / High Price $84.56 / $223.50 / $363.34	Professional		$84.56	$223.50	$363.34
Prevea360 Facility/Professional Facility Modifier Low / Median / High Price $83.34 / $168.69 / $333.57	Facility		$83.34	$168.69	$333.57
Quartz Facility/Professional Professional Modifier Low / Median / High Price $208.38 / $380.92 / $597.05	Professional		$208.38	$380.92	$597.05
Quartz Facility/Professional Facility Modifier Low / Median / High Price $631.79 / $631.79 / $631.79	Facility		$631.79	$631.79	$631.79
Quartz Facility/Professional Professional Modifier Low / Median / High Price $125.89 / $667.12 / $1,258.88	Professional		$125.89	$667.12	$1,258.88
Security Health Facility/Professional Professional Modifier Low / Median / High Price $389.50 / $453.78 / $866.12	Professional		$389.50	$453.78	$866.12
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 $160.25 / $444.65 / $802.65	Professional		$160.25	$444.65	$802.65