Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $41.07 / $52.61 / $184.78	Facility		$41.07	$52.61	$184.78
Aetna Facility/Professional Professional Modifier Low / Median / High Price $41.07 / $53.05 / $200.99	Professional		$41.07	$53.05	$200.99
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $1,139.00 / $1,183.00 / $1,530.00	Facility		$1,139.00	$1,183.00	$1,530.00
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $46.12 / $83.68 / $266.50	Professional		$46.12	$83.68	$266.50
CareSource Facility/Professional Facility Modifier Low / Median / High Price $37.15 / $46.59 / $58.19	Facility		$37.15	$46.59	$58.19
CareSource Facility/Professional Professional Modifier Low / Median / High Price $48.28 / $52.88 / $115.32	Professional		$48.28	$52.88	$115.32
Cigna Facility/Professional Facility Modifier Low / Median / High Price $131.56 / $153.74 / $235.84	Facility		$131.56	$153.74	$235.84
Cigna Facility/Professional Professional Modifier Low / Median / High Price $63.24 / $109.14 / $161.16	Professional		$63.24	$109.14	$161.16
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $40.69 / $55.30 / $102.68	Facility		$40.69	$55.30	$102.68
Medica Facility/Professional Facility Modifier Low / Median / High Price $40.69 / $64.98 / $1,590.00	Facility		$40.69	$64.98	$1,590.00
Medica Facility/Professional Professional Modifier Low / Median / High Price $59.67 / $112.44 / $312.52	Professional		$59.67	$112.44	$312.52
Molina Facility/Professional Professional Modifier Low / Median / High Price $40.93 / $66.47 / $139.59	Professional		$40.93	$66.47	$139.59
Prevea360 Facility/Professional Facility Modifier Low / Median / High Price $39.46 / $55.30 / $101.91	Facility		$39.46	$55.30	$101.91
Quartz Facility/Professional Professional Modifier Low / Median / High Price $78.00 / $117.55 / $166.60	Professional		$78.00	$117.55	$166.60
Quartz Facility/Professional Facility Modifier Low / Median / High Price $72.31 / $181.68 / $181.68	Facility		$72.31	$181.68	$181.68
Quartz Facility/Professional Professional Modifier Low / Median / High Price $70.30 / $232.35 / $312.52	Professional		$70.30	$232.35	$312.52
Security Health Facility/Professional Professional Modifier Low / Median / High Price $161.79 / $258.58 / $336.07	Professional		$161.79	$258.58	$336.07
United Facility/Professional Facility Modifier Low / Median / High Price $1,008.00 / $1,533.00 / $2,202.90	Facility		$1,008.00	$1,533.00	$2,202.90
United Facility/Professional Professional Modifier Low / Median / High Price $59.19 / $95.30 / $207.64	Professional		$59.19	$95.30	$207.64