Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $66.07 / $123.03 / $151.36	Facility		$66.07	$123.03	$151.36
Aetna Facility/Professional Professional Modifier Low / Median / High Price $40.74 / $46.77 / $134.90	Professional		$40.74	$46.77	$134.90
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $120.23 / $147.91 / $151.36	Facility		$120.23	$147.91	$151.36
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $22.39 / $22.39 / $194.98	Professional		$22.39	$22.39	$194.98
CareSource Facility/Professional Facility Modifier Low / Median / High Price $50.12 / $50.12 / $50.12	Facility		$50.12	$50.12	$50.12
Cigna Facility/Professional Facility Modifier Low / Median / High Price $154.88 / $177.83 / $288.40	Facility		$154.88	$177.83	$288.40
Cigna Facility/Professional Professional Modifier Low / Median / High Price $64.57 / $79.43 / $173.78	Professional		$64.57	$79.43	$173.78
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $27.54 / $204.17 / $323.59	Facility		$27.54	$204.17	$323.59
Medica Facility/Professional Facility Modifier Low / Median / High Price $27.54 / $66.07 / $263.03	Facility		$27.54	$66.07	$263.03
Medica Facility/Professional Professional Modifier Low / Median / High Price $27.54 / $33.11 / $100.00	Professional		$27.54	$33.11	$100.00
Molina Facility/Professional Professional Modifier Low / Median / High Price $27.54 / $64.57 / $154.88	Professional		$27.54	$64.57	$154.88
Quartz Facility/Professional Professional Modifier Low / Median / High Price $70.79 / $128.82 / $181.97	Professional		$70.79	$128.82	$181.97
Quartz Facility/Professional Facility Modifier Low / Median / High Price $112.20 / $112.20 / $263.03	Facility		$112.20	$112.20	$263.03
Quartz Facility/Professional Professional Modifier Low / Median / High Price $29.51 / $29.51 / $29.51	Professional		$29.51	$29.51	$29.51
Security Health Facility/Professional Professional Modifier Low / Median / High Price $117.49 / $117.49 / $117.49	Professional		$117.49	$117.49	$117.49
Security Health Facility/Professional Professional Modifier Low / Median / High Price $162.18 / $302.00 / $389.05	Professional		$162.18	$302.00	$389.05
United Facility/Professional Facility Modifier Low / Median / High Price $33.88 / $44.67 / $66.07	Facility		$33.88	$44.67	$66.07
United Facility/Professional Professional Modifier Low / Median / High Price $23.44 / $33.11 / $107.15	Professional		$23.44	$33.11	$107.15