Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $105.44 / $506.00 / $1,685.04	Facility		$105.44	$506.00	$1,685.04
Aetna Facility/Professional Professional Modifier Low / Median / High Price $112.76 / $229.49 / $770.11	Professional		$112.76	$229.49	$770.11
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 $135.72 / $258.23 / $655.90	Professional		$135.72	$258.23	$655.90
CareSource Facility/Professional Facility Modifier Low / Median / High Price $117.14 / $140.57 / $181.95	Facility		$117.14	$140.57	$181.95
CareSource Facility/Professional Professional Modifier Low / Median / High Price $132.21 / $139.60 / $194.03	Professional		$132.21	$139.60	$194.03
Cigna Facility/Professional Facility Modifier Low / Median / High Price $382.98 / $447.54 / $686.53	Facility		$382.98	$447.54	$686.53
Cigna Facility/Professional Professional Modifier Low / Median / High Price $186.32 / $367.80 / $646.10	Professional		$186.32	$367.80	$646.10
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $111.72 / $161.32 / $292.92	Facility		$111.72	$161.32	$292.92
Medica Facility/Professional Facility Modifier Low / Median / High Price $125.50 / $203.12 / $1,449.00	Facility		$125.50	$203.12	$1,449.00
Medica Facility/Professional Professional Modifier Low / Median / High Price $165.01 / $300.38 / $1,066.58	Professional		$165.01	$300.38	$1,066.58
Molina Facility/Professional Professional Modifier Low / Median / High Price $85.81 / $172.95 / $366.69	Professional		$85.81	$172.95	$366.69
Prevea360 Facility/Professional Facility Modifier Low / Median / High Price $111.72 / $159.40 / $292.92	Facility		$111.72	$159.40	$292.92
Quartz Facility/Professional Professional Modifier Low / Median / High Price $274.57 / $362.85 / $517.13	Professional		$274.57	$362.85	$517.13
Quartz Facility/Professional Facility Modifier Low / Median / High Price $140.88 / $140.88 / $561.65	Facility		$140.88	$140.88	$561.65
Quartz Facility/Professional Professional Modifier Low / Median / High Price $245.70 / $617.99 / $1,104.40	Professional		$245.70	$617.99	$1,104.40
Security Health Facility/Professional Professional Modifier Low / Median / High Price $485.61 / $665.79 / $851.39	Professional		$485.61	$665.79	$851.39
United Facility/Professional Facility Modifier Low / Median / High Price $1,008.00 / $1,370.00 / $2,202.90	Facility		$1,008.00	$1,370.00	$2,202.90
United Facility/Professional Professional Modifier Low / Median / High Price $158.69 / $276.48 / $622.08	Professional		$158.69	$276.48	$622.08