Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $41.69 / $117.49 / $117.49	Facility		$41.69	$117.49	$117.49
Aetna Facility/Professional Professional Modifier Low / Median / High Price $41.69 / $41.69 / $46.77	Professional		$41.69	$41.69	$46.77
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $14.45 / $16.98 / $147.91	Professional		$14.45	$16.98	$147.91
CareSource Facility/Professional Facility Modifier Low / Median / High Price $41.69 / $41.69 / $41.69	Facility		$41.69	$41.69	$41.69
Cigna Facility/Professional Facility Modifier Low / Median / High Price $93.33 / $123.03 / $173.78	Facility		$93.33	$123.03	$173.78
Cigna Facility/Professional Professional Modifier Low / Median / High Price $48.98 / $60.26 / $131.83	Professional		$48.98	$60.26	$131.83
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $42.66 / $173.78 / $245.47	Facility		$42.66	$173.78	$245.47
Medica Facility/Professional Facility Modifier Low / Median / High Price $42.66 / $42.66 / $199.53	Facility		$42.66	$42.66	$199.53
Medica Facility/Professional Professional Modifier Low / Median / High Price $21.38 / $25.12 / $72.44	Professional		$21.38	$25.12	$72.44
Molina Facility/Professional Professional Modifier Low / Median / High Price $21.38 / $54.95 / $85.11	Professional		$21.38	$54.95	$85.11
Quartz Facility/Professional Professional Modifier Low / Median / High Price $54.95 / $97.72 / $141.25	Professional		$54.95	$97.72	$141.25
Quartz Facility/Professional Facility Modifier Low / Median / High Price $85.11 / $85.11 / $199.53	Facility		$85.11	$85.11	$199.53
Quartz Facility/Professional Professional Modifier Low / Median / High Price $28.84 / $28.84 / $28.84	Professional		$28.84	$28.84	$28.84
Security Health Facility/Professional Professional Modifier Low / Median / High Price $42.66 / $42.66 / $89.13	Professional		$42.66	$42.66	$89.13
Security Health Facility/Professional Facility Modifier Low / Median / High Price $51.29 / $51.29 / $51.29	Facility		$51.29	$51.29	$51.29
Security Health Facility/Professional Professional Modifier Low / Median / High Price $42.66 / $42.66 / $229.09	Professional		$42.66	$42.66	$229.09
United Facility/Professional Facility Modifier Low / Median / High Price $33.88 / $33.88 / $51.29	Facility		$33.88	$33.88	$51.29
United Facility/Professional Professional Modifier Low / Median / High Price $17.78 / $25.12 / $81.28	Professional		$17.78	$25.12	$81.28