Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $97.06 / $258.44 / $3,119.00	Facility		$97.06	$258.44	$3,119.00
Aetna Facility/Professional Professional Modifier Low / Median / High Price $92.11 / $138.15 / $569.00	Professional		$92.11	$138.15	$569.00
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 $118.31 / $288.31 / $603.84	Professional		$118.31	$288.31	$603.84
CareSource Facility/Professional Professional Modifier Low / Median / High Price $269.67 / $269.67 / $269.67	Professional		$269.67	$269.67	$269.67
Cigna Facility/Professional Facility Modifier Low / Median / High Price $334.32 / $390.67 / $630.14	Facility		$334.32	$390.67	$630.14
Cigna Facility/Professional Professional Modifier Low / Median / High Price $164.09 / $302.41 / $439.74	Professional		$164.09	$302.41	$439.74
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $97.06 / $138.15 / $246.95	Facility		$97.06	$138.15	$246.95
Medica Facility/Professional Facility Modifier Low / Median / High Price $105.01 / $180.60 / $1,778.00	Facility		$105.01	$180.60	$1,778.00
Medica Facility/Professional Professional Modifier Low / Median / High Price $129.00 / $333.42 / $673.52	Professional		$129.00	$333.42	$673.52
Molina Facility/Professional Professional Modifier Low / Median / High Price $78.44 / $144.65 / $317.35	Professional		$78.44	$144.65	$317.35
Prevea360 Facility/Professional Facility Modifier Low / Median / High Price $94.54 / $137.83 / $246.95	Facility		$94.54	$137.83	$246.95
Quartz Facility/Professional Professional Modifier Low / Median / High Price $205.20 / $293.08 / $427.20	Professional		$205.20	$293.08	$427.20
Quartz Facility/Professional Facility Modifier Low / Median / High Price $424.76 / $424.76 / $424.76	Facility		$424.76	$424.76	$424.76
Quartz Facility/Professional Professional Modifier Low / Median / High Price $168.23 / $536.17 / $943.60	Professional		$168.23	$536.17	$943.60
Security Health Facility/Professional Professional Modifier Low / Median / High Price $284.02 / $486.18 / $688.73	Professional		$284.02	$486.18	$688.73
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 $126.18 / $333.45 / $496.61	Professional		$126.18	$333.45	$496.61