Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $251.19 / $467.74 / $575.44	Facility		$251.19	$467.74	$575.44
Aetna Facility/Professional Professional Modifier Low / Median / High Price $138.04 / $169.82 / $251.19	Professional		$138.04	$169.82	$251.19
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $446.68 / $562.34 / $575.44	Facility		$446.68	$562.34	$575.44
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $83.18 / $83.18 / $741.31	Professional		$83.18	$83.18	$741.31
CareSource Facility/Professional Facility Modifier Low / Median / High Price $134.90 / $134.90 / $134.90	Facility		$134.90	$134.90	$134.90
Cigna Facility/Professional Facility Modifier Low / Median / High Price $575.44 / $676.08 / $1,071.52	Facility		$575.44	$676.08	$1,071.52
Cigna Facility/Professional Professional Modifier Low / Median / High Price $239.88 / $302.00 / $660.69	Professional		$239.88	$302.00	$660.69
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $104.71 / $416.87 / $1,047.13	Facility		$104.71	$416.87	$1,047.13
Medica Facility/Professional Facility Modifier Low / Median / High Price $104.71 / $190.55 / $1,000.00	Facility		$104.71	$190.55	$1,000.00
Medica Facility/Professional Professional Modifier Low / Median / High Price $95.50 / $125.89 / $380.19	Professional		$95.50	$125.89	$380.19
Molina Facility/Professional Professional Modifier Low / Median / High Price $33.11 / $177.83 / $316.23	Professional		$33.11	$177.83	$316.23
Quartz Facility/Professional Professional Modifier Low / Median / High Price $269.15 / $537.03 / $741.31	Professional		$269.15	$537.03	$741.31
Quartz Facility/Professional Facility Modifier Low / Median / High Price $416.87 / $416.87 / $1,000.00	Facility		$416.87	$416.87	$1,000.00
Quartz Facility/Professional Professional Modifier Low / Median / High Price $79.43 / $87.10 / $125.89	Professional		$79.43	$87.10	$125.89
Security Health Facility/Professional Professional Modifier Low / Median / High Price $134.90 / $134.90 / $446.68	Professional		$134.90	$134.90	$446.68
Security Health Facility/Professional Professional Modifier Low / Median / High Price $134.90 / $524.81 / $1,148.15	Professional		$134.90	$524.81	$1,148.15
United Facility/Professional Facility Modifier Low / Median / High Price $104.71 / $165.96 / $251.19	Facility		$104.71	$165.96	$251.19
United Facility/Professional Professional Modifier Low / Median / High Price $87.10 / $125.89 / $389.05	Professional		$87.10	$125.89	$389.05