Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $102.66 / $218.50 / $1,894.00	Facility		$102.66	$218.50	$1,894.00
Aetna Facility/Professional Professional Modifier Low / Median / High Price $110.64 / $175.75 / $818.40	Professional		$110.64	$175.75	$818.40
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 $145.28 / $358.19 / $761.14	Professional		$145.28	$358.19	$761.14
CareSource Facility/Professional Facility Modifier Low / Median / High Price $103.43 / $157.86 / $157.86	Facility		$103.43	$157.86	$157.86
CareSource Facility/Professional Professional Modifier Low / Median / High Price $152.41 / $224.36 / $346.78	Professional		$152.41	$224.36	$346.78
Cigna Facility/Professional Facility Modifier Low / Median / High Price $425.33 / $497.03 / $801.69	Facility		$425.33	$497.03	$801.69
Cigna Facility/Professional Professional Modifier Low / Median / High Price $178.63 / $357.75 / $545.61	Professional		$178.63	$357.75	$545.61
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $115.77 / $175.75 / $314.61	Facility		$115.77	$175.75	$314.61
Medica Facility/Professional Facility Modifier Low / Median / High Price $124.30 / $214.25 / $1,778.00	Facility		$124.30	$214.25	$1,778.00
Medica Facility/Professional Professional Modifier Low / Median / High Price $165.83 / $432.53 / $800.88	Professional		$165.83	$432.53	$800.88
Molina Facility/Professional Professional Modifier Low / Median / High Price $85.00 / $190.00 / $414.04	Professional		$85.00	$190.00	$414.04
Prevea360 Facility/Professional Facility Modifier Low / Median / High Price $115.77 / $175.75 / $314.61	Facility		$115.77	$175.75	$314.61
Quartz Facility/Professional Professional Modifier Low / Median / High Price $249.40 / $370.96 / $546.36	Professional		$249.40	$370.96	$546.36
Quartz Facility/Professional Facility Modifier Low / Median / High Price $504.64 / $504.64 / $504.64	Facility		$504.64	$504.64	$504.64
Quartz Facility/Professional Professional Modifier Low / Median / High Price $164.18 / $682.88 / $1,203.59	Professional		$164.18	$682.88	$1,203.59
Security Health Facility/Professional Professional Modifier Low / Median / High Price $369.49 / $575.14 / $877.11	Professional		$369.49	$575.14	$877.11
United Facility/Professional Facility Modifier Low / Median / High Price $1,034.00 / $1,590.00 / $2,202.90	Facility		$1,034.00	$1,590.00	$2,202.90
United Facility/Professional Professional Modifier Low / Median / High Price $162.50 / $371.78 / $640.13	Professional		$162.50	$371.78	$640.13