Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $95.92 / $947.00 / $3,840.86	Facility		$95.92	$947.00	$3,840.86
Aetna Facility/Professional Professional Modifier Low / Median / High Price $55.02 / $185.79 / $603.90	Professional		$55.02	$185.79	$603.90
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 $77.12 / $212.87 / $508.26	Professional		$77.12	$212.87	$508.26
CareSource Facility/Professional Facility Modifier Low / Median / High Price $47.80 / $72.20 / $72.20	Facility		$47.80	$72.20	$72.20
CareSource Facility/Professional Professional Modifier Low / Median / High Price $102.96 / $144.97 / $224.09	Professional		$102.96	$144.97	$224.09
Cigna Facility/Professional Facility Modifier Low / Median / High Price $297.37 / $347.50 / $560.51	Facility		$297.37	$347.50	$560.51
Cigna Facility/Professional Professional Modifier Low / Median / High Price $92.25 / $173.27 / $376.85	Professional		$92.25	$173.27	$376.85
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $55.02 / $107.97 / $214.98	Facility		$55.02	$107.97	$214.98
Medica Facility/Professional Facility Modifier Low / Median / High Price $59.03 / $143.21 / $2,090.40	Facility		$59.03	$143.21	$2,090.40
Medica Facility/Professional Professional Modifier Low / Median / High Price $93.83 / $234.18 / $536.54	Professional		$93.83	$234.18	$536.54
Molina Facility/Professional Professional Modifier Low / Median / High Price $70.00 / $197.94 / $250.69	Professional		$70.00	$197.94	$250.69
Prevea360 Facility/Professional Facility Modifier Low / Median / High Price $51.43 / $105.45 / $214.98	Facility		$51.43	$105.45	$214.98
Quartz Facility/Professional Professional Modifier Low / Median / High Price $115.26 / $209.82 / $365.37	Professional		$115.26	$209.82	$365.37
Quartz Facility/Professional Facility Modifier Low / Median / High Price $228.57 / $228.57 / $228.57	Facility		$228.57	$228.57	$228.57
Quartz Facility/Professional Professional Modifier Low / Median / High Price $85.57 / $260.26 / $822.08	Professional		$85.57	$260.26	$822.08
Security Health Facility/Professional Professional Modifier Low / Median / High Price $126.44 / $126.44 / $284.20	Professional		$126.44	$126.44	$284.20
Security Health Facility/Professional Professional Modifier Low / Median / High Price $140.24 / $272.52 / $605.82	Professional		$140.24	$272.52	$605.82
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 $91.35 / $222.18 / $389.47	Professional		$91.35	$222.18	$389.47