Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $315.58 / $586.47 / $1,166.95	Facility		$315.58	$586.47	$1,166.95
Aetna Facility/Professional Professional Modifier Low / Median / High Price $170.94 / $238.73 / $361.16	Professional		$170.94	$238.73	$361.16
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $565.42 / $683.77 / $723.22	Facility		$565.42	$683.77	$723.22
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $105.40 / $262.99 / $1,126.44	Professional		$105.40	$262.99	$1,126.44
CareSource Facility/Professional Facility Modifier Low / Median / High Price $262.99 / $642.73 / $667.99	Facility		$262.99	$642.73	$667.99
CareSource Facility/Professional Professional Modifier Low / Median / High Price $262.99 / $262.99 / $315.58	Professional		$262.99	$262.99	$315.58
Cigna Facility/Professional Facility Modifier Low / Median / High Price $723.60 / $845.58 / $1,297.15	Facility		$723.60	$845.58	$1,297.15
Cigna Facility/Professional Professional Modifier Low / Median / High Price $302.32 / $708.18 / $804.75	Professional		$302.32	$708.18	$804.75
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $202.50 / $315.58 / $920.47	Facility		$202.50	$315.58	$920.47
Medica Facility/Professional Facility Modifier Low / Median / High Price $202.50 / $315.58 / $1,885.44	Facility		$202.50	$315.58	$1,885.44
Medica Facility/Professional Professional Modifier Low / Median / High Price $121.99 / $174.27 / $812.56	Professional		$121.99	$174.27	$812.56
Molina Facility/Professional Professional Modifier Low / Median / High Price $50.00 / $70.00 / $232.94	Professional		$50.00	$70.00	$232.94
Prevea360 Facility/Professional Facility Modifier Low / Median / High Price $202.50 / $315.58 / $920.47	Facility		$202.50	$315.58	$920.47
Quartz Facility/Professional Professional Modifier Low / Median / High Price $528.45 / $641.29 / $879.50	Professional		$528.45	$641.29	$879.50
Quartz Facility/Professional Facility Modifier Low / Median / High Price $525.98 / $1,249.20 / $1,249.20	Facility		$525.98	$1,249.20	$1,249.20
Quartz Facility/Professional Professional Modifier Low / Median / High Price $269.72 / $1,314.95 / $1,314.95	Professional		$269.72	$1,314.95	$1,314.95
Security Health Facility/Professional Professional Modifier Low / Median / High Price $219.58 / $219.58 / $560.04	Professional		$219.58	$219.58	$560.04
Security Health Facility/Professional Professional Modifier Low / Median / High Price $219.58 / $764.31 / $1,435.93	Professional		$219.58	$764.31	$1,435.93
United Facility/Professional Professional Modifier Low / Median / High Price $121.99 / $174.44 / $698.80	Professional		$121.99	$174.44	$698.80