Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $102.33 / $223.87 / $616.60	Facility		$102.33	$223.87	$616.60
Aetna Facility/Professional Professional Modifier Low / Median / High Price $47.86 / $64.57 / $288.40	Professional		$47.86	$64.57	$288.40
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $158.49 / $199.53 / $199.53	Facility		$158.49	$199.53	$199.53
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $30.20 / $30.20 / $302.00	Professional		$30.20	$30.20	$302.00
CareSource Facility/Professional Facility Modifier Low / Median / High Price $74.13 / $109.65 / $186.21	Facility		$74.13	$109.65	$186.21
CareSource Facility/Professional Professional Modifier Low / Median / High Price $74.13 / $81.28 / $102.33	Professional		$74.13	$81.28	$102.33
Cigna Facility/Professional Facility Modifier Low / Median / High Price $204.17 / $234.42 / $380.19	Facility		$204.17	$234.42	$380.19
Cigna Facility/Professional Professional Modifier Low / Median / High Price $85.11 / $177.83 / $229.09	Professional		$85.11	$177.83	$229.09
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $81.28 / $338.84 / $489.78	Facility		$81.28	$338.84	$489.78
DeanCare Facility/Professional Professional Modifier Low / Median / High Price $436.52 / $436.52 / $489.78	Professional		$436.52	$436.52	$489.78
Medica Facility/Professional Facility Modifier Low / Median / High Price $69.18 / $128.82 / $338.84	Facility		$69.18	$128.82	$338.84
Medica Facility/Professional Professional Modifier Low / Median / High Price $39.81 / $50.12 / $363.08	Professional		$39.81	$50.12	$363.08
Molina Facility/Professional Professional Modifier Low / Median / High Price $50.12 / $64.57 / $75.86	Professional		$50.12	$64.57	$75.86
Quartz Facility/Professional Professional Modifier Low / Median / High Price $128.82 / $173.78 / $251.19	Professional		$128.82	$173.78	$251.19
Quartz Facility/Professional Facility Modifier Low / Median / High Price $147.91 / $346.74 / $346.74	Facility		$147.91	$346.74	$346.74
Quartz Facility/Professional Professional Modifier Low / Median / High Price $87.10 / $363.08 / $363.08	Professional		$87.10	$363.08	$363.08
Security Health Facility/Professional Professional Modifier Low / Median / High Price $63.10 / $63.10 / $154.88	Professional		$63.10	$63.10	$154.88
Security Health Facility/Professional Professional Modifier Low / Median / High Price $63.10 / $204.17 / $398.11	Professional		$63.10	$204.17	$398.11
United Facility/Professional Facility Modifier Low / Median / High Price $58.88 / $58.88 / $87.10	Facility		$58.88	$58.88	$87.10
United Facility/Professional Professional Modifier Low / Median / High Price $30.90 / $47.86 / $134.90	Professional		$30.90	$47.86	$134.90