Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $213.80 / $398.11 / $489.78	Facility		$213.80	$398.11	$489.78
Aetna Facility/Professional Professional Modifier Low / Median / High Price $123.03 / $144.54 / $213.80	Professional		$123.03	$144.54	$213.80
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $380.19 / $478.63 / $489.78	Facility		$380.19	$478.63	$489.78
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $70.79 / $70.79 / $630.96	Professional		$70.79	$70.79	$630.96
CareSource Facility/Professional Facility Modifier Low / Median / High Price $162.18 / $162.18 / $162.18	Facility		$162.18	$162.18	$162.18
Cigna Facility/Professional Facility Modifier Low / Median / High Price $489.78 / $575.44 / $912.01	Facility		$489.78	$575.44	$912.01
Cigna Facility/Professional Professional Modifier Low / Median / High Price $204.17 / $257.04 / $549.54	Professional		$204.17	$257.04	$549.54
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $89.13 / $354.81 / $1,047.13	Facility		$89.13	$354.81	$1,047.13
Medica Facility/Professional Facility Modifier Low / Median / High Price $89.13 / $158.49 / $851.14	Facility		$89.13	$158.49	$851.14
Medica Facility/Professional Professional Modifier Low / Median / High Price $89.13 / $107.15 / $316.23	Professional		$89.13	$107.15	$316.23
Molina Facility/Professional Professional Modifier Low / Median / High Price $54.95 / $87.10 / $269.15	Professional		$54.95	$87.10	$269.15
Quartz Facility/Professional Professional Modifier Low / Median / High Price $229.09 / $416.87 / $588.84	Professional		$229.09	$416.87	$588.84
Quartz Facility/Professional Facility Modifier Low / Median / High Price $354.81 / $354.81 / $851.14	Facility		$354.81	$354.81	$851.14
Quartz Facility/Professional Professional Modifier Low / Median / High Price $81.28 / $81.28 / $81.28	Professional		$81.28	$81.28	$81.28
Security Health Facility/Professional Professional Modifier Low / Median / High Price $134.90 / $134.90 / $380.19	Professional		$134.90	$134.90	$380.19
Security Health Facility/Professional Professional Modifier Low / Median / High Price $134.90 / $512.86 / $977.24	Professional		$134.90	$512.86	$977.24
United Facility/Professional Facility Modifier Low / Median / High Price $97.72 / $141.25 / $213.80	Facility		$97.72	$141.25	$213.80
United Facility/Professional Professional Modifier Low / Median / High Price $74.13 / $107.15 / $346.74	Professional		$74.13	$107.15	$346.74