Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $80.19 / $309.47 / $5,558.16	Facility		$80.19	$309.47	$5,558.16
Aetna Facility/Professional Professional Modifier Low / Median / High Price $76.34 / $180.81 / $709.75	Professional		$76.34	$180.81	$709.75
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 $120.31 / $295.27 / $703.40	Professional		$120.31	$295.27	$703.40
CareSource Facility/Professional Facility Modifier Low / Median / High Price $71.14 / $107.55 / $107.55	Facility		$71.14	$107.55	$107.55
CareSource Facility/Professional Professional Modifier Low / Median / High Price $141.75 / $201.65 / $311.69	Professional		$141.75	$201.65	$311.69
Cigna Facility/Professional Facility Modifier Low / Median / High Price $411.81 / $481.23 / $776.21	Facility		$411.81	$481.23	$776.21
Cigna Facility/Professional Professional Modifier Low / Median / High Price $135.56 / $250.03 / $521.49	Professional		$135.56	$250.03	$521.49
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $74.68 / $148.65 / $295.70	Facility		$74.68	$148.65	$295.70
Medica Facility/Professional Facility Modifier Low / Median / High Price $80.19 / $186.78 / $3,995.00	Facility		$80.19	$186.78	$3,995.00
Medica Facility/Professional Professional Modifier Low / Median / High Price $157.36 / $393.60 / $744.22	Professional		$157.36	$393.60	$744.22
Molina Facility/Professional Professional Modifier Low / Median / High Price $77.22 / $172.51 / $338.03	Professional		$77.22	$172.51	$338.03
Prevea360 Facility/Professional Facility Modifier Low / Median / High Price $74.18 / $145.96 / $295.70	Facility		$74.18	$145.96	$295.70
Quartz Facility/Professional Professional Modifier Low / Median / High Price $173.27 / $293.80 / $508.14	Professional		$173.27	$293.80	$508.14
Quartz Facility/Professional Facility Modifier Low / Median / High Price $351.44 / $351.44 / $351.44	Facility		$351.44	$351.44	$351.44
Quartz Facility/Professional Professional Modifier Low / Median / High Price $126.22 / $589.95 / $1,138.48	Professional		$126.22	$589.95	$1,138.48
Security Health Facility/Professional Professional Modifier Low / Median / High Price $198.97 / $401.98 / $838.39	Professional		$198.97	$401.98	$838.39
United Facility/Professional Facility Modifier Low / Median / High Price $2,367.00 / $3,088.30 / $4,295.00	Facility		$2,367.00	$3,088.30	$4,295.00
United Facility/Professional Professional Modifier Low / Median / High Price $143.85 / $386.98 / $607.72	Professional		$143.85	$386.98	$607.72