Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $107.60 / $309.49 / $3,707.03	Facility		$107.60	$309.49	$3,707.03
Aetna Facility/Professional Professional Modifier Low / Median / High Price $103.27 / $165.73 / $704.21	Professional		$103.27	$165.73	$704.21
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 $134.41 / $342.14 / $707.82	Professional		$134.41	$342.14	$707.82
CareSource Facility/Professional Facility Modifier Low / Median / High Price $95.17 / $144.90 / $144.90	Facility		$95.17	$144.90	$144.90
CareSource Facility/Professional Professional Modifier Low / Median / High Price $143.08 / $209.31 / $323.52	Professional		$143.08	$209.31	$323.52
Cigna Facility/Professional Facility Modifier Low / Median / High Price $401.00 / $468.60 / $755.83	Facility		$401.00	$468.60	$755.83
Cigna Facility/Professional Professional Modifier Low / Median / High Price $168.55 / $311.24 / $514.34	Professional		$168.55	$311.24	$514.34
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $107.60 / $165.73 / $295.73	Facility		$107.60	$165.73	$295.73
Medica Facility/Professional Facility Modifier Low / Median / High Price $115.05 / $204.10 / $1,778.00	Facility		$115.05	$204.10	$1,778.00
Medica Facility/Professional Professional Modifier Low / Median / High Price $156.53 / $407.03 / $746.32	Professional		$156.53	$407.03	$746.32
Molina Facility/Professional Professional Modifier Low / Median / High Price $78.44 / $179.73 / $353.71	Professional		$78.44	$179.73	$353.71
Prevea360 Facility/Professional Facility Modifier Low / Median / High Price $107.60 / $165.73 / $295.73	Facility		$107.60	$165.73	$295.73
Quartz Facility/Professional Professional Modifier Low / Median / High Price $229.57 / $342.45 / $511.51	Professional		$229.57	$342.45	$511.51
Quartz Facility/Professional Facility Modifier Low / Median / High Price $470.36 / $470.36 / $470.36	Facility		$470.36	$470.36	$470.36
Quartz Facility/Professional Professional Modifier Low / Median / High Price $153.69 / $643.73 / $1,134.24	Professional		$153.69	$643.73	$1,134.24
Security Health Facility/Professional Professional Modifier Low / Median / High Price $350.79 / $535.89 / $826.81	Professional		$350.79	$535.89	$826.81
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 $156.53 / $407.03 / $604.04	Professional		$156.53	$407.03	$604.04