Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $269.15 / $549.54 / $645.65	Facility		$269.15	$549.54	$645.65
Aetna Facility/Professional Professional Modifier Low / Median / High Price $151.36 / $177.83 / $263.03	Professional		$151.36	$177.83	$263.03
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $467.74 / $588.84 / $602.56	Facility		$467.74	$588.84	$602.56
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $87.10 / $87.10 / $758.58	Professional		$87.10	$87.10	$758.58
CareSource Facility/Professional Facility Modifier Low / Median / High Price $218.78 / $218.78 / $218.78	Facility		$218.78	$218.78	$218.78
CareSource Facility/Professional Professional Modifier Low / Median / High Price $218.78 / $218.78 / $218.78	Professional		$218.78	$218.78	$218.78
Cigna Facility/Professional Facility Modifier Low / Median / High Price $602.56 / $707.95 / $1,122.02	Facility		$602.56	$707.95	$1,122.02
Cigna Facility/Professional Professional Modifier Low / Median / High Price $251.19 / $316.23 / $676.08	Professional		$251.19	$316.23	$676.08
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $112.20 / $758.58 / $1,288.25	Facility		$112.20	$758.58	$1,288.25
Medica Facility/Professional Facility Modifier Low / Median / High Price $112.20 / $263.03 / $1,047.13	Facility		$112.20	$263.03	$1,047.13
Medica Facility/Professional Professional Modifier Low / Median / High Price $109.65 / $131.83 / $389.05	Professional		$109.65	$131.83	$389.05
Molina Facility/Professional Professional Modifier Low / Median / High Price $12.02 / $54.95 / $323.59	Professional		$12.02	$54.95	$323.59
Quartz Facility/Professional Professional Modifier Low / Median / High Price $281.84 / $512.86 / $724.44	Professional		$281.84	$512.86	$724.44
Quartz Facility/Professional Facility Modifier Low / Median / High Price $436.52 / $436.52 / $1,047.13	Facility		$436.52	$436.52	$1,047.13
Quartz Facility/Professional Professional Modifier Low / Median / High Price $104.71 / $104.71 / $114.82	Professional		$104.71	$104.71	$114.82
Security Health Facility/Professional Professional Modifier Low / Median / High Price $218.78 / $218.78 / $467.74	Professional		$218.78	$218.78	$467.74
Security Health Facility/Professional Facility Modifier Low / Median / High Price $1,096.48 / $1,318.26 / $1,513.56	Facility		$1,096.48	$1,318.26	$1,513.56
Security Health Facility/Professional Professional Modifier Low / Median / High Price $218.78 / $630.96 / $1,202.26	Professional		$218.78	$630.96	$1,202.26
United Facility/Professional Facility Modifier Low / Median / High Price $173.78 / $173.78 / $263.03	Facility		$173.78	$173.78	$263.03
United Facility/Professional Professional Modifier Low / Median / High Price $91.20 / $131.83 / $426.58	Professional		$91.20	$131.83	$426.58