Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $58.88 / $114.82 / $12,022.64	Facility		$58.88	$114.82	$12,022.64
Aetna Facility/Professional Professional Modifier Low / Median / High Price $57.54 / $57.54 / $4,897.79	Professional		$57.54	$57.54	$4,897.79
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $70.79 / $70.79 / $128.82	Facility		$70.79	$70.79	$128.82
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $57.54 / $57.54 / $72.44	Professional		$57.54	$57.54	$72.44
CareSource Facility/Professional Facility Modifier Low / Median / High Price $79.43 / $79.43 / $83.18	Facility		$79.43	$79.43	$83.18
Cigna Facility/Professional Facility Modifier Low / Median / High Price $57.54 / $66.07 / $151.36	Facility		$57.54	$66.07	$151.36
Cigna Facility/Professional Professional Modifier Low / Median / High Price $57.54 / $72.44 / $104.71	Professional		$57.54	$72.44	$104.71
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $40.74 / $56.23 / $123.03	Facility		$40.74	$56.23	$123.03
DeanCare Facility/Professional Professional Modifier Low / Median / High Price $83.18 / $112.20 / $112.20	Professional		$83.18	$112.20	$112.20
Medica Facility/Professional Facility Modifier Low / Median / High Price $40.74 / $56.23 / $123.03	Facility		$40.74	$56.23	$123.03
Medica Facility/Professional Professional Modifier Low / Median / High Price $56.23 / $56.23 / $89.13	Professional		$56.23	$56.23	$89.13
Molina Facility/Professional Professional Modifier Low / Median / High Price $64.57 / $64.57 / $85.11	Professional		$64.57	$64.57	$85.11
Quartz Facility/Professional Professional Modifier Low / Median / High Price $57.54 / $57.54 / $169.82	Professional		$57.54	$57.54	$169.82
Quartz Facility/Professional Facility Modifier Low / Median / High Price $57.54 / $57.54 / $281.84	Facility		$57.54	$57.54	$281.84
Quartz Facility/Professional Professional Modifier Low / Median / High Price $57.54 / $57.54 / $57.54	Professional		$57.54	$57.54	$57.54
Security Health Facility/Professional Professional Modifier Low / Median / High Price $54.95 / $77.62 / $95.50	Professional		$54.95	$77.62	$95.50
United Facility/Professional Facility Modifier Low / Median / High Price $54.95 / $54.95 / $57.54	Facility		$54.95	$54.95	$57.54
United Facility/Professional Professional Modifier Low / Median / High Price $57.54 / $57.54 / $77.62	Professional		$57.54	$57.54	$77.62