Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $97.72 / $588.84 / $1,000.00	Facility		$97.72	$588.84	$1,000.00
Aetna Facility/Professional Professional Modifier Low / Median / High Price $93.33 / $100.00 / $316.23	Professional		$93.33	$100.00	$316.23
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $117.49 / $117.49 / $208.93	Facility		$117.49	$117.49	$208.93
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $93.33 / $93.33 / $120.23	Professional		$93.33	$93.33	$120.23
CareSource Facility/Professional Facility Modifier Low / Median / High Price $131.83 / $131.83 / $141.25	Facility		$131.83	$131.83	$141.25
Cigna Facility/Professional Facility Modifier Low / Median / High Price $93.33 / $190.55 / $331.13	Facility		$93.33	$190.55	$331.13
Cigna Facility/Professional Professional Modifier Low / Median / High Price $93.33 / $120.23 / $173.78	Professional		$93.33	$120.23	$173.78
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $81.28 / $95.50 / $208.93	Facility		$81.28	$95.50	$208.93
DeanCare Facility/Professional Professional Modifier Low / Median / High Price $23.99 / $190.55 / $190.55	Professional		$23.99	$190.55	$190.55
Medica Facility/Professional Facility Modifier Low / Median / High Price $93.33 / $194.98 / $245.47	Facility		$93.33	$194.98	$245.47
Medica Facility/Professional Professional Modifier Low / Median / High Price $93.33 / $93.33 / $151.36	Professional		$93.33	$93.33	$151.36
Molina Facility/Professional Professional Modifier Low / Median / High Price $64.57 / $85.11 / $93.33	Professional		$64.57	$85.11	$93.33
Quartz Facility/Professional Professional Modifier Low / Median / High Price $93.33 / $102.33 / $281.84	Professional		$93.33	$102.33	$281.84
Quartz Facility/Professional Facility Modifier Low / Median / High Price $93.33 / $93.33 / $707.95	Facility		$93.33	$93.33	$707.95
Quartz Facility/Professional Professional Modifier Low / Median / High Price $93.33 / $93.33 / $93.33	Professional		$93.33	$93.33	$93.33
Security Health Facility/Professional Professional Modifier Low / Median / High Price $109.65 / $128.82 / $158.49	Professional		$109.65	$128.82	$158.49
United Facility/Professional Facility Modifier Low / Median / High Price $91.20 / $91.20 / $93.33	Facility		$91.20	$91.20	$93.33
United Facility/Professional Professional Modifier Low / Median / High Price $93.33 / $93.33 / $128.82	Professional		$93.33	$93.33	$128.82