Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $125.89 / $4,677.35 / $18,620.87	Facility		$125.89	$4,677.35	$18,620.87
Aetna Facility/Professional Professional Modifier Low / Median / High Price $123.03 / $125.89 / $5,011.87	Professional		$123.03	$125.89	$5,011.87
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $154.88 / $154.88 / $275.42	Facility		$154.88	$154.88	$275.42
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $123.03 / $123.03 / $154.88	Professional		$123.03	$123.03	$154.88
CareSource Facility/Professional Facility Modifier Low / Median / High Price $131.83 / $165.96 / $165.96	Facility		$131.83	$165.96	$165.96
Cigna Facility/Professional Facility Modifier Low / Median / High Price $47.86 / $91.20 / $123.03	Facility		$47.86	$91.20	$123.03
Cigna Facility/Professional Professional Modifier Low / Median / High Price $123.03 / $154.88 / $251.19	Professional		$123.03	$154.88	$251.19
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $89.13 / $89.13 / $194.98	Facility		$89.13	$89.13	$194.98
DeanCare Facility/Professional Professional Modifier Low / Median / High Price $134.90 / $177.83 / $177.83	Professional		$134.90	$177.83	$177.83
Medica Facility/Professional Facility Modifier Low / Median / High Price $58.88 / $128.82 / $912.01	Facility		$58.88	$128.82	$912.01
Medica Facility/Professional Professional Modifier Low / Median / High Price $58.88 / $64.57 / $177.83	Professional		$58.88	$64.57	$177.83
Molina Facility/Professional Professional Modifier Low / Median / High Price $64.57 / $85.11 / $123.03	Professional		$64.57	$85.11	$123.03
Quartz Facility/Professional Professional Modifier Low / Median / High Price $123.03 / $128.82 / $363.08	Professional		$123.03	$128.82	$363.08
Quartz Facility/Professional Facility Modifier Low / Median / High Price $123.03 / $123.03 / $645.65	Facility		$123.03	$123.03	$645.65
Quartz Facility/Professional Professional Modifier Low / Median / High Price $123.03 / $123.03 / $123.03	Professional		$123.03	$123.03	$123.03
Security Health Facility/Professional Professional Modifier Low / Median / High Price $173.78 / $173.78 / $229.09	Professional		$173.78	$173.78	$229.09
United Facility/Professional Facility Modifier Low / Median / High Price $19.95 / $19.95 / $123.03	Facility		$19.95	$19.95	$123.03
United Facility/Professional Professional Modifier Low / Median / High Price $123.03 / $138.04 / $186.21	Professional		$123.03	$138.04	$186.21