Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $141.97 / $342.65 / $5,146.00	Facility		$141.97	$342.65	$5,146.00
Aetna Facility/Professional Professional Modifier Low / Median / High Price $136.44 / $257.00 / $997.02	Professional		$136.44	$257.00	$997.02
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 $166.98 / $400.59 / $847.46	Professional		$166.98	$400.59	$847.46
CareSource Facility/Professional Facility Modifier Low / Median / High Price $126.71 / $192.65 / $192.65	Facility		$126.71	$192.65	$192.65
CareSource Facility/Professional Professional Modifier Low / Median / High Price $159.15 / $236.57 / $365.66	Professional		$159.15	$236.57	$365.66
Cigna Facility/Professional Facility Modifier Low / Median / High Price $440.65 / $514.92 / $830.57	Facility		$440.65	$514.92	$830.57
Cigna Facility/Professional Professional Modifier Low / Median / High Price $217.41 / $397.00 / $623.94	Professional		$217.41	$397.00	$623.94
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $141.97 / $183.44 / $327.42	Facility		$141.97	$183.44	$327.42
Medica Facility/Professional Facility Modifier Low / Median / High Price $147.43 / $257.55 / $1,789.00	Facility		$147.43	$257.55	$1,789.00
Medica Facility/Professional Professional Modifier Low / Median / High Price $183.84 / $458.98 / $987.60	Professional		$183.84	$458.98	$987.60
Molina Facility/Professional Professional Modifier Low / Median / High Price $78.44 / $203.69 / $442.10	Professional		$78.44	$203.69	$442.10
Prevea360 Facility/Professional Facility Modifier Low / Median / High Price $137.46 / $182.75 / $327.42	Facility		$137.46	$182.75	$327.42
Quartz Facility/Professional Professional Modifier Low / Median / High Price $297.95 / $412.80 / $569.97	Professional		$297.95	$412.80	$569.97
Quartz Facility/Professional Facility Modifier Low / Median / High Price $622.88 / $622.88 / $622.88	Facility		$622.88	$622.88	$622.88
Quartz Facility/Professional Professional Modifier Low / Median / High Price $245.90 / $709.52 / $1,255.20	Professional		$245.90	$709.52	$1,255.20
Security Health Facility/Professional Professional Modifier Low / Median / High Price $398.61 / $710.64 / $911.37	Professional		$398.61	$710.64	$911.37
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 $175.09 / $406.09 / $684.03	Professional		$175.09	$406.09	$684.03