Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $218.78 / $218.78 / $309.03	Facility		$218.78	$218.78	$309.03
Aetna Facility/Professional Professional Modifier Low / Median / High Price $95.50 / $162.18 / $457.09	Professional		$95.50	$162.18	$457.09
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $123.03 / $177.83 / $346.74	Professional		$123.03	$177.83	$346.74
CareSource Facility/Professional Facility Modifier Low / Median / High Price $114.82 / $154.88 / $208.93	Facility		$114.82	$154.88	$208.93
CareSource Facility/Professional Professional Modifier Low / Median / High Price $120.23 / $154.88 / $239.88	Professional		$120.23	$154.88	$239.88
Cigna Facility/Professional Facility Modifier Low / Median / High Price $281.84 / $371.54 / $588.84	Facility		$281.84	$371.54	$588.84
Cigna Facility/Professional Professional Modifier Low / Median / High Price $120.23 / $245.47 / $371.54	Professional		$120.23	$245.47	$371.54
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $93.33 / $125.89 / $251.19	Facility		$93.33	$125.89	$251.19
DeanCare Facility/Professional Professional Modifier Low / Median / High Price $213.80 / $263.03 / $338.84	Professional		$213.80	$263.03	$338.84
Medica Facility/Professional Facility Modifier Low / Median / High Price $93.33 / $131.83 / $257.04	Facility		$93.33	$131.83	$257.04
Medica Facility/Professional Professional Modifier Low / Median / High Price $123.03 / $199.53 / $1,071.52	Professional		$123.03	$199.53	$1,071.52
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.36 / $33.11 / $85.11	Professional		$32.36	$33.11	$85.11
Quartz Facility/Professional Professional Modifier Low / Median / High Price $141.25 / $239.88 / $354.81	Professional		$141.25	$239.88	$354.81
Quartz Facility/Professional Facility Modifier Low / Median / High Price $223.87 / $223.87 / $758.58	Facility		$223.87	$223.87	$758.58
Quartz Facility/Professional Professional Modifier Low / Median / High Price $114.82 / $602.56 / $1,071.52	Professional		$114.82	$602.56	$1,071.52
Security Health Facility/Professional Professional Modifier Low / Median / High Price $208.93 / $208.93 / $208.93	Professional		$208.93	$208.93	$208.93
Security Health Facility/Professional Professional Modifier Low / Median / High Price $173.78 / $257.04 / $389.05	Professional		$173.78	$257.04	$389.05
United Facility/Professional Professional Modifier Low / Median / High Price $123.03 / $169.82 / $302.00	Professional		$123.03	$169.82	$302.00