Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $75.86 / $112.20 / $218.78	Facility		$75.86	$112.20	$218.78
Aetna Facility/Professional Professional Modifier Low / Median / High Price $79.43 / $117.49 / $363.08	Professional		$79.43	$117.49	$363.08
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $104.71 / $169.82 / $302.00	Professional		$104.71	$169.82	$302.00
CareSource Facility/Professional Facility Modifier Low / Median / High Price $125.89 / $144.54 / $229.09	Facility		$125.89	$144.54	$229.09
CareSource Facility/Professional Professional Modifier Low / Median / High Price $109.65 / $134.90 / $269.15	Professional		$109.65	$134.90	$269.15
Cigna Facility/Professional Facility Modifier Low / Median / High Price $309.03 / $363.08 / $575.44	Facility		$309.03	$363.08	$575.44
Cigna Facility/Professional Professional Modifier Low / Median / High Price $100.00 / $245.47 / $389.05	Professional		$100.00	$245.47	$389.05
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $89.13 / $109.65 / $204.17	Facility		$89.13	$109.65	$204.17
DeanCare Facility/Professional Professional Modifier Low / Median / High Price $234.42 / $269.15 / $331.13	Professional		$234.42	$269.15	$331.13
Medica Facility/Professional Facility Modifier Low / Median / High Price $91.20 / $109.65 / $204.17	Facility		$91.20	$109.65	$204.17
Medica Facility/Professional Professional Modifier Low / Median / High Price $102.33 / $218.78 / $707.95	Professional		$102.33	$218.78	$707.95
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.36 / $33.11 / $134.90	Professional		$32.36	$33.11	$134.90
Quartz Facility/Professional Professional Modifier Low / Median / High Price $165.96 / $251.19 / $354.81	Professional		$165.96	$251.19	$354.81
Quartz Facility/Professional Facility Modifier Low / Median / High Price $218.78 / $707.95 / $707.95	Facility		$218.78	$707.95	$707.95
Quartz Facility/Professional Professional Modifier Low / Median / High Price $107.15 / $512.86 / $691.83	Professional		$107.15	$512.86	$691.83
Security Health Facility/Professional Professional Modifier Low / Median / High Price $177.83 / $346.74 / $398.11	Professional		$177.83	$346.74	$398.11
United Facility/Professional Facility Modifier Low / Median / High Price $85.11 / $85.11 / $112.20	Facility		$85.11	$85.11	$112.20
United Facility/Professional Professional Modifier Low / Median / High Price $100.00 / $158.49 / $281.84	Professional		$100.00	$158.49	$281.84