Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Professional Modifier Low / Median / High Price $19.05 / $19.05 / $257.04	Professional		$19.05	$19.05	$257.04
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $5.50 / $5.50 / $70.79	Professional		$5.50	$5.50	$70.79
CareSource Facility/Professional Facility Modifier Low / Median / High Price $24.55 / $58.88 / $60.26	Facility		$24.55	$58.88	$60.26
CareSource Facility/Professional Professional Modifier Low / Median / High Price $22.91 / $22.91 / $22.91	Professional		$22.91	$22.91	$22.91
Cigna Facility/Professional Facility Modifier Low / Median / High Price $53.70 / $61.66 / $100.00	Facility		$53.70	$61.66	$100.00
Cigna Facility/Professional Professional Modifier Low / Median / High Price $24.55 / $31.62 / $74.13	Professional		$24.55	$31.62	$74.13
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $17.38 / $17.38 / $43.65	Facility		$17.38	$17.38	$43.65
Medica Facility/Professional Facility Modifier Low / Median / High Price $17.38 / $17.38 / $112.20	Facility		$17.38	$17.38	$112.20
Medica Facility/Professional Professional Modifier Low / Median / High Price $12.02 / $16.98 / $50.12	Professional		$12.02	$16.98	$50.12
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.36 / $54.95 / $3,019.95	Professional		$32.36	$54.95	$3,019.95
Quartz Facility/Professional Professional Modifier Low / Median / High Price $30.90 / $54.95 / $79.43	Professional		$30.90	$54.95	$79.43
Quartz Facility/Professional Facility Modifier Low / Median / High Price $50.12 / $50.12 / $151.36	Facility		$50.12	$50.12	$151.36
United Facility/Professional Facility Modifier Low / Median / High Price $12.02 / $13.49 / $19.50	Facility		$12.02	$13.49	$19.50
United Facility/Professional Professional Modifier Low / Median / High Price $10.23 / $16.22 / $50.12	Professional		$10.23	$16.22	$50.12