Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
CareSource Facility/Professional Facility Modifier Low / Median / High Price $125.89 / $158.49 / $173.78	Facility		$125.89	$158.49	$173.78
CareSource Facility/Professional Professional Modifier Low / Median / High Price $93.33 / $131.83 / $138.04	Professional		$93.33	$131.83	$138.04
Cigna Facility/Professional Facility Modifier Low / Median / High Price $234.42 / $275.42 / $436.52	Facility		$234.42	$275.42	$436.52
Cigna Facility/Professional Professional Modifier Low / Median / High Price $97.72 / $147.91 / $165.96	Professional		$97.72	$147.91	$165.96
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $85.11 / $181.97 / $446.68	Facility		$85.11	$181.97	$446.68
DeanCare Facility/Professional Professional Modifier Low / Median / High Price $177.83 / $177.83 / $177.83	Professional		$177.83	$177.83	$177.83
Medica Facility/Professional Facility Modifier Low / Median / High Price $109.65 / $275.42 / $1,318.26	Facility		$109.65	$275.42	$1,318.26
Medica Facility/Professional Professional Modifier Low / Median / High Price $371.54 / $676.08 / $1,778.28	Professional		$371.54	$676.08	$1,778.28
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.36 / $50.12 / $70.79	Professional		$32.36	$50.12	$70.79
Quartz Facility/Professional Facility Modifier Low / Median / High Price $269.15 / $2,630.27 / $2,630.27	Facility		$269.15	$2,630.27	$2,630.27
Quartz Facility/Professional Professional Modifier Low / Median / High Price $1,778.28 / $1,778.28 / $1,778.28	Professional		$1,778.28	$1,778.28	$1,778.28
United Facility/Professional Professional Modifier Low / Median / High Price $331.13 / $575.44 / $1,288.25	Professional		$331.13	$575.44	$1,288.25