Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $34.67 / $151.36 / $467.74	Facility		$34.67	$151.36	$467.74
Aetna Facility/Professional Professional Modifier Low / Median / High Price $15.85 / $28.18 / $109.65	Professional		$15.85	$28.18	$109.65
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $1,584.89 / $3,090.30 / $5,754.40	Facility		$1,584.89	$3,090.30	$5,754.40
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $19.50 / $44.67 / $138.04	Professional		$19.50	$44.67	$138.04
CareSource Facility/Professional Facility Modifier Low / Median / High Price $14.13 / $14.13 / $14.13	Facility		$14.13	$14.13	$14.13
CareSource Facility/Professional Professional Modifier Low / Median / High Price $52.48 / $52.48 / $58.88	Professional		$52.48	$52.48	$58.88
Cigna Facility/Professional Facility Modifier Low / Median / High Price $74.13 / $87.10 / $138.04	Facility		$74.13	$87.10	$138.04
Cigna Facility/Professional Professional Modifier Low / Median / High Price $27.54 / $52.48 / $100.00	Professional		$27.54	$52.48	$100.00
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $10.72 / $29.51 / $3,311.31	Facility		$10.72	$29.51	$3,311.31
DeanCare Facility/Professional Professional Modifier Low / Median / High Price $35.48 / $48.98 / $81.28	Professional		$35.48	$48.98	$81.28
Medica Facility/Professional Facility Modifier Low / Median / High Price $13.80 / $35.48 / $1,584.89	Facility		$13.80	$35.48	$1,584.89
Medica Facility/Professional Professional Modifier Low / Median / High Price $35.48 / $61.66 / $177.83	Professional		$35.48	$61.66	$177.83
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.36 / $33.11 / $70.79	Professional		$32.36	$33.11	$70.79
Quartz Facility/Professional Professional Modifier Low / Median / High Price $23.99 / $45.71 / $91.20	Professional		$23.99	$45.71	$91.20
Quartz Facility/Professional Facility Modifier Low / Median / High Price $38.90 / $38.90 / $1,288.25	Facility		$38.90	$38.90	$1,288.25
Quartz Facility/Professional Professional Modifier Low / Median / High Price $28.18 / $102.33 / $199.53	Professional		$28.18	$102.33	$199.53
Security Health Facility/Professional Professional Modifier Low / Median / High Price $63.10 / $107.15 / $194.98	Professional		$63.10	$107.15	$194.98
United Facility/Professional Facility Modifier Low / Median / High Price $954.99 / $1,548.82 / $1,949.84	Facility		$954.99	$1,548.82	$1,949.84
United Facility/Professional Professional Modifier Low / Median / High Price $19.05 / $48.98 / $123.03	Professional		$19.05	$48.98	$123.03