Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $218.76 / $1,296.00 / $1,950.00	Facility		$218.76	$1,296.00	$1,950.00
Aetna Facility/Professional Facility Modifier 25 Low / Median / High Price $700.29 / $1,257.00 / $2,214.30	Facility	25	$700.29	$1,257.00	$2,214.30
Aetna Facility/Professional Professional Modifier Low / Median / High Price $91.69 / $137.33 / $566.62	Professional		$91.69	$137.33	$566.62
Aetna Facility/Professional Professional Modifier 25 Low / Median / High Price $92.97 / $412.04 / $813.41	Professional	25	$92.97	$412.04	$813.41
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $2,592.00 / $2,693.00 / $3,274.00	Facility		$2,592.00	$2,693.00	$3,274.00
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $113.42 / $268.07 / $443.84	Professional		$113.42	$268.07	$443.84
CareSource Facility/Professional Facility Modifier Low / Median / High Price $114.40 / $149.66 / $336.90	Facility		$114.40	$149.66	$336.90
CareSource Facility/Professional Professional Modifier Low / Median / High Price $115.12 / $126.71 / $271.33	Professional		$115.12	$126.71	$271.33
Cigna Facility/Professional Facility Modifier Low / Median / High Price $306.38 / $358.03 / $549.23	Facility		$306.38	$358.03	$549.23
Cigna Facility/Professional Professional Modifier Low / Median / High Price $131.25 / $307.83 / $399.61	Professional		$131.25	$307.83	$399.61
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $102.67 / $140.11 / $326.56	Facility		$102.67	$140.11	$326.56
Medica Facility/Professional Facility Modifier Low / Median / High Price $102.67 / $140.11 / $331.88	Facility		$102.67	$140.11	$331.88
Medica Facility/Professional Facility Modifier 25 Low / Median / High Price $316.49 / $389.66 / $1,694.05	Facility	25	$316.49	$389.66	$1,694.05
Medica Facility/Professional Professional Modifier Low / Median / High Price $134.18 / $274.08 / $748.12	Professional		$134.18	$274.08	$748.12
Medica Facility/Professional Professional Modifier 25 Low / Median / High Price $204.13 / $436.42 / $600.66	Professional	25	$204.13	$436.42	$600.66
Molina Facility/Professional Professional Modifier Low / Median / High Price $79.39 / $197.71 / $275.34	Professional		$79.39	$197.71	$275.34
Prevea360 Facility/Professional Facility Modifier Low / Median / High Price $102.67 / $136.10 / $277.49	Facility		$102.67	$136.10	$277.49
Quartz Facility/Professional Professional Modifier Low / Median / High Price $226.08 / $323.70 / $499.47	Professional		$226.08	$323.70	$499.47
Quartz Facility/Professional Facility Modifier Low / Median / High Price $544.99 / $544.99 / $544.99	Facility		$544.99	$544.99	$544.99
Quartz Facility/Professional Professional Modifier Low / Median / High Price $156.77 / $572.20 / $748.12	Professional		$156.77	$572.20	$748.12
Security Health Facility/Professional Professional Modifier Low / Median / High Price $215.61 / $396.15 / $437.52	Professional		$215.61	$396.15	$437.52
United Facility/Professional Professional Modifier Low / Median / High Price $126.13 / $216.24 / $422.41	Professional		$126.13	$216.24	$422.41