Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $73.86 / $160.54 / $1,894.00	Facility		$73.86	$160.54	$1,894.00
Aetna Facility/Professional Professional Modifier Low / Median / High Price $75.48 / $129.38 / $403.33	Professional		$75.48	$129.38	$403.33
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 $116.82 / $180.88 / $476.96	Professional		$116.82	$180.88	$476.96
CareSource Facility/Professional Facility Modifier Low / Median / High Price $74.05 / $88.86 / $111.90	Facility		$74.05	$88.86	$111.90
CareSource Facility/Professional Professional Modifier Low / Median / High Price $119.45 / $125.42 / $165.77	Professional		$119.45	$125.42	$165.77
Cigna Facility/Professional Facility Modifier Low / Median / High Price $360.45 / $421.21 / $646.15	Facility		$360.45	$421.21	$646.15
Cigna Facility/Professional Professional Modifier Low / Median / High Price $141.86 / $305.79 / $602.25	Professional		$141.86	$305.79	$602.25
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $75.51 / $132.94 / $270.81	Facility		$75.51	$132.94	$270.81
Medica Facility/Professional Facility Modifier Low / Median / High Price $78.84 / $160.54 / $3,034.00	Facility		$78.84	$160.54	$3,034.00
Medica Facility/Professional Professional Modifier Low / Median / High Price $170.83 / $313.81 / $1,124.13	Professional		$170.83	$313.81	$1,124.13
Molina Facility/Professional Professional Modifier Low / Median / High Price $77.91 / $132.94 / $300.25	Professional		$77.91	$132.94	$300.25
Prevea360 Facility/Professional Facility Modifier Low / Median / High Price $75.51 / $132.94 / $270.81	Facility		$75.51	$132.94	$270.81
Quartz Facility/Professional Professional Modifier Low / Median / High Price $178.47 / $284.39 / $444.06	Professional		$178.47	$284.39	$444.06
Quartz Facility/Professional Facility Modifier Low / Median / High Price $354.23 / $354.23 / $982.04	Facility		$354.23	$354.23	$982.04
Quartz Facility/Professional Professional Modifier Low / Median / High Price $180.64 / $576.04 / $1,240.00	Professional		$180.64	$576.04	$1,240.00
Security Health Facility/Professional Professional Modifier Low / Median / High Price $316.02 / $498.96 / $793.60	Professional		$316.02	$498.96	$793.60
United Facility/Professional Facility Modifier Low / Median / High Price $1,957.00 / $3,068.00 / $4,295.00	Facility		$1,957.00	$3,068.00	$4,295.00
United Facility/Professional Professional Modifier Low / Median / High Price $160.27 / $302.44 / $655.11	Professional		$160.27	$302.44	$655.11