Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $234.27 / $701.69 / $3,899.00	Facility		$234.27	$701.69	$3,899.00
Aetna Facility/Professional Facility Modifier 25 Low / Median / High Price $2,232.69 / $3,344.90 / $6,888.84	Facility	25	$2,232.69	$3,344.90	$6,888.84
Aetna Facility/Professional Professional Modifier Low / Median / High Price $181.54 / $264.02 / $1,145.70	Professional		$181.54	$264.02	$1,145.70
Aetna Facility/Professional Professional Modifier 25 Low / Median / High Price $198.70 / $600.07 / $2,133.50	Professional	25	$198.70	$600.07	$2,133.50
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $5,557.00 / $5,773.00 / $7,443.00	Facility		$5,557.00	$5,773.00	$7,443.00
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $246.09 / $385.24 / $687.93	Professional		$246.09	$385.24	$687.93
CareSource Facility/Professional Facility Modifier Low / Median / High Price $202.11 / $252.64 / $336.80	Facility		$202.11	$252.64	$336.80
CareSource Facility/Professional Professional Modifier Low / Median / High Price $256.62 / $299.98 / $526.76	Professional		$256.62	$299.98	$526.76
Cigna Facility/Professional Facility Modifier Low / Median / High Price $718.19 / $839.26 / $1,287.45	Facility		$718.19	$839.26	$1,287.45
Cigna Facility/Professional Professional Modifier Low / Median / High Price $230.29 / $517.22 / $763.96	Professional		$230.29	$517.22	$763.96
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $181.54 / $250.91 / $540.73	Facility		$181.54	$250.91	$540.73
Medica Facility/Professional Facility Modifier Low / Median / High Price $181.54 / $253.67 / $543.02	Facility		$181.54	$253.67	$543.02
Medica Facility/Professional Facility Modifier 25 Low / Median / High Price $1,298.88 / $1,298.88 / $1,298.88	Facility	25	$1,298.88	$1,298.88	$1,298.88
Medica Facility/Professional Professional Modifier Low / Median / High Price $288.20 / $571.84 / $1,733.52	Professional		$288.20	$571.84	$1,733.52
Medica Facility/Professional Professional Modifier 25 Low / Median / High Price $359.00 / $1,037.77 / $1,371.60	Professional	25	$359.00	$1,037.77	$1,371.60
Molina Facility/Professional Professional Modifier Low / Median / High Price $158.09 / $387.75 / $557.03	Professional		$158.09	$387.75	$557.03
Prevea360 Facility/Professional Facility Modifier Low / Median / High Price $181.54 / $249.84 / $540.73	Facility		$181.54	$249.84	$540.73
Quartz Facility/Professional Professional Modifier Low / Median / High Price $413.40 / $626.17 / $826.42	Professional		$413.40	$626.17	$826.42
Quartz Facility/Professional Facility Modifier Low / Median / High Price $286.33 / $962.77 / $1,047.88	Facility		$286.33	$962.77	$1,047.88
Quartz Facility/Professional Professional Modifier Low / Median / High Price $299.26 / $1,162.22 / $1,733.52	Professional		$299.26	$1,162.22	$1,733.52
Security Health Facility/Professional Professional Modifier Low / Median / High Price $375.23 / $609.84 / $792.67	Professional		$375.23	$609.84	$792.67
United Facility/Professional Professional Modifier Low / Median / High Price $274.01 / $618.58 / $953.08	Professional		$274.01	$618.58	$953.08