Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $329.80 / $412.25 / $1,057.94	Facility		$329.80	$412.25	$1,057.94
Aetna Facility/Professional Professional Modifier Low / Median / High Price $211.62 / $329.80 / $392.96	Professional		$211.62	$329.80	$392.96
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $590.88 / $714.56 / $755.78	Facility		$590.88	$714.56	$755.78
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $109.93 / $274.83 / $1,177.15	Professional		$109.93	$274.83	$1,177.15
CareSource Facility/Professional Facility Modifier Low / Median / High Price $274.83 / $408.19 / $727.64	Facility		$274.83	$408.19	$727.64
CareSource Facility/Professional Professional Modifier Low / Median / High Price $274.83 / $288.57 / $355.50	Professional		$274.83	$288.57	$355.50
Cigna Facility/Professional Facility Modifier Low / Median / High Price $756.04 / $883.49 / $1,355.30	Facility		$756.04	$883.49	$1,355.30
Cigna Facility/Professional Professional Modifier Low / Median / High Price $315.95 / $740.06 / $840.98	Professional		$315.95	$740.06	$840.98
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $211.62 / $329.80 / $961.91	Facility		$211.62	$329.80	$961.91
Medica Facility/Professional Facility Modifier Low / Median / High Price $247.35 / $329.80 / $961.91	Facility		$247.35	$329.80	$961.91
Medica Facility/Professional Professional Modifier Low / Median / High Price $137.41 / $164.90 / $847.53	Professional		$137.41	$164.90	$847.53
Molina Facility/Professional Professional Modifier Low / Median / High Price $50.00 / $70.00 / $137.41	Professional		$50.00	$70.00	$137.41
Prevea360 Facility/Professional Facility Modifier Low / Median / High Price $211.62 / $329.80 / $961.91	Facility		$211.62	$329.80	$961.91
Quartz Facility/Professional Professional Modifier Low / Median / High Price $522.27 / $670.48 / $919.53	Professional		$522.27	$670.48	$919.53
Quartz Facility/Professional Facility Modifier Low / Median / High Price $827.74 / $1,305.44 / $1,305.44	Facility		$827.74	$1,305.44	$1,305.44
Quartz Facility/Professional Professional Modifier Low / Median / High Price $398.50 / $1,374.15 / $1,374.15	Professional		$398.50	$1,374.15	$1,374.15
Security Health Facility/Professional Professional Modifier Low / Median / High Price $274.83 / $274.83 / $585.26	Professional		$274.83	$274.83	$585.26
Security Health Facility/Professional Professional Modifier Low / Median / High Price $274.83 / $274.83 / $1,500.57	Professional		$274.83	$274.83	$1,500.57
United Facility/Professional Professional Modifier Low / Median / High Price $123.67 / $164.90 / $511.57	Professional		$123.67	$164.90	$511.57