Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $91.20 / $1,516.24 / $2,269.09	Facility		$91.20	$1,516.24	$2,269.09
Aetna Facility/Professional Professional Modifier Low / Median / High Price $79.31 / $218.13 / $715.40	Professional		$79.31	$218.13	$715.40
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $1,139.00 / $2,455.00 / $4,441.52	Facility		$1,139.00	$2,455.00	$4,441.52
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $91.99 / $214.56 / $477.93	Professional		$91.99	$214.56	$477.93
CareSource Facility/Professional Facility Modifier Low / Median / High Price $78.56 / $100.20 / $131.90	Facility		$78.56	$100.20	$131.90
CareSource Facility/Professional Professional Modifier Low / Median / High Price $227.41 / $241.45 / $434.61	Professional		$227.41	$241.45	$434.61
Cigna Facility/Professional Facility Modifier Low / Median / High Price $598.34 / $699.21 / $1,072.60	Facility		$598.34	$699.21	$1,072.60
Cigna Facility/Professional Professional Modifier Low / Median / High Price $146.03 / $372.66 / $990.16	Professional		$146.03	$372.66	$990.16
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $79.31 / $202.24 / $366.67	Facility		$79.31	$202.24	$366.67
Medica Facility/Professional Facility Modifier Low / Median / High Price $79.84 / $216.15 / $911.99	Facility		$79.84	$216.15	$911.99
Medica Facility/Professional Professional Modifier Low / Median / High Price $325.86 / $634.88 / $1,646.48	Professional		$325.86	$634.88	$1,646.48
Molina Facility/Professional Professional Modifier Low / Median / High Price $132.51 / $219.47 / $551.40	Professional		$132.51	$219.47	$551.40
Prevea360 Facility/Professional Facility Modifier Low / Median / High Price $79.31 / $202.24 / $366.67	Facility		$79.31	$202.24	$366.67
Quartz Facility/Professional Professional Modifier Low / Median / High Price $164.45 / $287.31 / $709.66	Professional		$164.45	$287.31	$709.66
Quartz Facility/Professional Facility Modifier Low / Median / High Price $493.70 / $493.70 / $493.70	Facility		$493.70	$493.70	$493.70
Quartz Facility/Professional Facility Modifier 52 Low / Median / High Price $306.41 / $306.41 / $306.41	Facility	52	$306.41	$306.41	$306.41
Quartz Facility/Professional Facility Modifier 53 Low / Median / High Price $76.59 / $76.59 / $76.59	Facility	53	$76.59	$76.59	$76.59
Quartz Facility/Professional Professional Modifier Low / Median / High Price $356.45 / $634.88 / $1,646.48	Professional		$356.45	$634.88	$1,646.48
Security Health Facility/Professional Professional Modifier Low / Median / High Price $315.29 / $491.08 / $1,304.72	Professional		$315.29	$491.08	$1,304.72
United Facility/Professional Facility Modifier Low / Median / High Price $2,257.00 / $3,088.30 / $4,295.00	Facility		$2,257.00	$3,088.30	$4,295.00
United Facility/Professional Professional Modifier Low / Median / High Price $280.70 / $587.04 / $1,100.88	Professional		$280.70	$587.04	$1,100.88