Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $74.13 / $169.82 / $169.82	Facility		$74.13	$169.82	$169.82
Aetna Facility/Professional Professional Modifier Low / Median / High Price $42.66 / $50.12 / $74.13	Professional		$42.66	$50.12	$74.13
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $134.90 / $165.96 / $169.82	Facility		$134.90	$165.96	$169.82
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $38.90 / $45.71 / $208.93	Professional		$38.90	$45.71	$208.93
CareSource Facility/Professional Facility Modifier Low / Median / High Price $42.66 / $42.66 / $42.66	Facility		$42.66	$42.66	$42.66
Cigna Facility/Professional Facility Modifier Low / Median / High Price $169.82 / $199.53 / $316.23	Facility		$169.82	$199.53	$316.23
Cigna Facility/Professional Professional Modifier Low / Median / High Price $70.79 / $89.13 / $194.98	Professional		$70.79	$89.13	$194.98
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $43.65 / $213.80 / $363.08	Facility		$43.65	$213.80	$363.08
Medica Facility/Professional Facility Modifier Low / Median / High Price $33.11 / $58.88 / $295.12	Facility		$33.11	$58.88	$295.12
Medica Facility/Professional Professional Modifier Low / Median / High Price $30.90 / $37.15 / $112.20	Professional		$30.90	$37.15	$112.20
Molina Facility/Professional Professional Modifier Low / Median / High Price $30.90 / $54.95 / $85.11	Professional		$30.90	$54.95	$85.11
Quartz Facility/Professional Professional Modifier Low / Median / High Price $79.43 / $144.54 / $204.17	Professional		$79.43	$144.54	$204.17
Quartz Facility/Professional Facility Modifier Low / Median / High Price $123.03 / $123.03 / $295.12	Facility		$123.03	$123.03	$295.12
Quartz Facility/Professional Professional Modifier Low / Median / High Price $33.11 / $33.11 / $33.11	Professional		$33.11	$33.11	$33.11
Security Health Facility/Professional Professional Modifier Low / Median / High Price $131.83 / $131.83 / $131.83	Professional		$131.83	$131.83	$131.83
Security Health Facility/Professional Professional Modifier Low / Median / High Price $181.97 / $338.84 / $467.74	Professional		$181.97	$338.84	$467.74
United Facility/Professional Facility Modifier Low / Median / High Price $50.12 / $50.12 / $74.13	Facility		$50.12	$50.12	$74.13
United Facility/Professional Professional Modifier Low / Median / High Price $26.30 / $37.15 / $120.23	Professional		$26.30	$37.15	$120.23