Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $89.89 / $89.89 / $111.11	Professional		$89.89	$89.89	$111.11
CareSource Facility/Professional Facility Modifier Low / Median / High Price $72.86 / $72.86 / $99.65	Facility		$72.86	$72.86	$99.65
Cigna Facility/Professional Facility Modifier Low / Median / High Price $242.40 / $283.27 / $376.48	Facility		$242.40	$283.27	$376.48
Cigna Facility/Professional Professional Modifier Low / Median / High Price $134.09 / $183.69 / $273.36	Professional		$134.09	$183.69	$273.36
Medica Facility/Professional Facility Modifier Low / Median / High Price $260.33 / $260.33 / $260.33	Facility		$260.33	$260.33	$260.33
Medica Facility/Professional Professional Modifier Low / Median / High Price $411.91 / $565.95 / $565.95	Professional		$411.91	$565.95	$565.95
Molina Facility/Professional Professional Modifier Low / Median / High Price $58.40 / $58.40 / $58.40	Professional		$58.40	$58.40	$58.40
Quartz Facility/Professional Professional Modifier Low / Median / High Price $60.04 / $75.37 / $199.89	Professional		$60.04	$75.37	$199.89
Quartz Facility/Professional Facility Modifier Low / Median / High Price $126.06 / $126.06 / $260.33	Facility		$126.06	$126.06	$260.33
Quartz Facility/Professional Professional Modifier Low / Median / High Price $279.45 / $411.91 / $565.95	Professional		$279.45	$411.91	$565.95