Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $40.74 / $93.33 / $93.33	Facility		$40.74	$93.33	$93.33
Aetna Facility/Professional Professional Modifier Low / Median / High Price $10.00 / $28.18 / $40.74	Professional		$10.00	$28.18	$40.74
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $74.13 / $91.20 / $93.33	Facility		$74.13	$91.20	$93.33
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $5.37 / $6.46 / $117.49	Professional		$5.37	$6.46	$117.49
CareSource Facility/Professional Facility Modifier Low / Median / High Price $23.44 / $23.44 / $23.44	Facility		$23.44	$23.44	$23.44
Cigna Facility/Professional Facility Modifier Low / Median / High Price $93.33 / $109.65 / $173.78	Facility		$93.33	$109.65	$173.78
Cigna Facility/Professional Professional Modifier Low / Median / High Price $38.90 / $51.29 / $107.15	Professional		$38.90	$51.29	$107.15
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $12.59 / $31.62 / $63.10	Facility		$12.59	$31.62	$63.10
Medica Facility/Professional Facility Modifier Low / Median / High Price $12.59 / $32.36 / $69.18	Facility		$12.59	$32.36	$69.18
Medica Facility/Professional Professional Modifier Low / Median / High Price $16.98 / $20.89 / $63.10	Professional		$16.98	$20.89	$63.10
Molina Facility/Professional Professional Modifier Low / Median / High Price $51.29 / $54.95 / $85.11	Professional		$51.29	$54.95	$85.11
Quartz Facility/Professional Professional Modifier Low / Median / High Price $43.65 / $79.43 / $112.20	Professional		$43.65	$79.43	$112.20
Quartz Facility/Professional Facility Modifier Low / Median / High Price $67.61 / $67.61 / $162.18	Facility		$67.61	$67.61	$162.18
Security Health Facility/Professional Professional Modifier Low / Median / High Price $72.44 / $72.44 / $72.44	Professional		$72.44	$72.44	$72.44
Security Health Facility/Professional Professional Modifier Low / Median / High Price $100.00 / $186.21 / $257.04	Professional		$100.00	$186.21	$257.04
United Facility/Professional Facility Modifier Low / Median / High Price $27.54 / $28.18 / $40.74	Facility		$27.54	$28.18	$40.74
United Facility/Professional Professional Modifier Low / Median / High Price $14.79 / $20.89 / $66.07	Professional		$14.79	$20.89	$66.07