Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $53.01 / $298.20 / $947.00	Facility		$53.01	$298.20	$947.00
Aetna Facility/Professional Professional Modifier Low / Median / High Price $28.84 / $90.60 / $307.00	Professional		$28.84	$90.60	$307.00
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $1,314.00 / $2,856.00 / $4,638.00	Facility		$1,314.00	$2,856.00	$4,638.00
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $42.53 / $103.15 / $281.72	Professional		$42.53	$103.15	$281.72
CareSource Facility/Professional Facility Modifier Low / Median / High Price $32.54 / $39.06 / $46.59	Facility		$32.54	$39.06	$46.59
CareSource Facility/Professional Professional Modifier Low / Median / High Price $92.62 / $101.88 / $122.20	Professional		$92.62	$101.88	$122.20
Cigna Facility/Professional Facility Modifier Low / Median / High Price $174.16 / $312.32 / $364.97	Facility		$174.16	$312.32	$364.97
Cigna Facility/Professional Professional Modifier Low / Median / High Price $35.82 / $88.55 / $248.33	Professional		$35.82	$88.55	$248.33
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $35.70 / $100.08 / $271.23	Facility		$35.70	$100.08	$271.23
Medica Facility/Professional Facility Modifier Low / Median / High Price $39.07 / $124.78 / $1,455.00	Facility		$39.07	$124.78	$1,455.00
Medica Facility/Professional Professional Modifier Low / Median / High Price $58.89 / $93.90 / $377.66	Professional		$58.89	$93.90	$377.66
Molina Facility/Professional Professional Modifier Low / Median / High Price $58.91 / $94.25 / $200.74	Professional		$58.91	$94.25	$200.74
Prevea360 Facility/Professional Facility Modifier Low / Median / High Price $35.70 / $100.08 / $271.23	Facility		$35.70	$100.08	$271.23
Quartz Facility/Professional Professional Modifier Low / Median / High Price $68.25 / $145.11 / $317.39	Professional		$68.25	$145.11	$317.39
Quartz Facility/Professional Facility Modifier Low / Median / High Price $66.59 / $83.25 / $247.68	Facility		$66.59	$83.25	$247.68
Quartz Facility/Professional Professional Modifier Low / Median / High Price $37.56 / $180.10 / $651.16	Professional		$37.56	$180.10	$651.16
Security Health Facility/Professional Professional Modifier Low / Median / High Price $44.31 / $122.65 / $354.93	Professional		$44.31	$122.65	$354.93
United Facility/Professional Facility Modifier Low / Median / High Price $1,034.00 / $1,423.00 / $2,202.90	Facility		$1,034.00	$1,423.00	$2,202.90
United Facility/Professional Professional Modifier Low / Median / High Price $68.37 / $93.90 / $187.80	Professional		$68.37	$93.90	$187.80