Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $316.23 / $316.23 / $316.23	Facility		$316.23	$316.23	$316.23
Aetna Facility/Professional Professional Modifier Low / Median / High Price $234.42 / $288.40 / $380.19	Professional		$234.42	$288.40	$380.19
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $467.74 / $467.74 / $758.58	Facility		$467.74	$467.74	$758.58
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $302.00 / $426.58 / $489.78	Professional		$302.00	$426.58	$489.78
CareSource Facility/Professional Facility Modifier Low / Median / High Price $46.77 / $66.07 / $89.13	Facility		$46.77	$66.07	$89.13
CareSource Facility/Professional Professional Modifier Low / Median / High Price $46.77 / $66.07 / $107.15	Professional		$46.77	$66.07	$107.15
Cigna Facility/Professional Facility Modifier Low / Median / High Price $316.23 / $1,513.56 / $2,398.83	Facility		$316.23	$1,513.56	$2,398.83
Cigna Facility/Professional Professional Modifier Low / Median / High Price $269.15 / $602.56 / $691.83	Professional		$269.15	$602.56	$691.83
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $70.79 / $251.19 / $371.54	Facility		$70.79	$251.19	$371.54
DeanCare Facility/Professional Professional Modifier Low / Median / High Price $41.69 / $208.93 / $281.84	Professional		$41.69	$208.93	$281.84
Medica Facility/Professional Facility Modifier Low / Median / High Price $70.79 / $199.53 / $371.54	Facility		$70.79	$199.53	$371.54
Medica Facility/Professional Professional Modifier Low / Median / High Price $22.91 / $30.90 / $51.29	Professional		$22.91	$30.90	$51.29
Molina Facility/Professional Professional Modifier Low / Median / High Price $50.12 / $64.57 / $70.79	Professional		$50.12	$64.57	$70.79
Quartz Facility/Professional Professional Modifier Low / Median / High Price $48.98 / $93.33 / $144.54	Professional		$48.98	$93.33	$144.54
Quartz Facility/Professional Facility Modifier Low / Median / High Price $64.57 / $100.00 / $316.23	Facility		$64.57	$100.00	$316.23
Quartz Facility/Professional Professional Modifier Low / Median / High Price $93.33 / $269.15 / $316.23	Professional		$93.33	$269.15	$316.23
United Facility/Professional Facility Modifier Low / Median / High Price $25.70 / $33.11 / $1,202.26	Facility		$25.70	$33.11	$1,202.26
United Facility/Professional Professional Modifier Low / Median / High Price $17.38 / $30.90 / $51.29	Professional		$17.38	$30.90	$51.29