Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $53.70 / $239.88 / $467.74	Facility		$53.70	$239.88	$467.74
Aetna Facility/Professional Professional Modifier Low / Median / High Price $28.84 / $33.88 / $72.44	Professional		$28.84	$33.88	$72.44
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $83.18 / $104.71 / $107.15	Facility		$83.18	$104.71	$107.15
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $19.05 / $19.05 / $154.88	Professional		$19.05	$19.05	$154.88
CareSource Facility/Professional Facility Modifier Low / Median / High Price $25.70 / $107.15 / $109.65	Facility		$25.70	$107.15	$109.65
CareSource Facility/Professional Professional Modifier Low / Median / High Price $38.90 / $38.90 / $38.90	Professional		$38.90	$38.90	$38.90
Cigna Facility/Professional Facility Modifier Low / Median / High Price $107.15 / $123.03 / $199.53	Facility		$107.15	$123.03	$199.53
Cigna Facility/Professional Professional Modifier Low / Median / High Price $44.67 / $54.95 / $120.23	Professional		$44.67	$54.95	$120.23
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $34.67 / $85.11 / $309.03	Facility		$34.67	$85.11	$309.03
Medica Facility/Professional Facility Modifier Low / Median / High Price $31.62 / $46.77 / $363.08	Facility		$31.62	$46.77	$363.08
Medica Facility/Professional Professional Modifier Low / Median / High Price $22.91 / $32.36 / $95.50	Professional		$22.91	$32.36	$95.50
Molina Facility/Professional Professional Modifier Low / Median / High Price $19.05 / $54.95 / $85.11	Professional		$19.05	$54.95	$85.11
Quartz Facility/Professional Professional Modifier Low / Median / High Price $50.12 / $97.72 / $213.80	Professional		$50.12	$97.72	$213.80
Quartz Facility/Professional Facility Modifier Low / Median / High Price $77.62 / $77.62 / $181.97	Facility		$77.62	$77.62	$181.97
Quartz Facility/Professional Professional Modifier Low / Median / High Price $20.42 / $25.70 / $38.02	Professional		$20.42	$25.70	$38.02
Security Health Facility/Professional Professional Modifier Low / Median / High Price $40.74 / $40.74 / $83.18	Professional		$40.74	$40.74	$83.18
Security Health Facility/Professional Professional Modifier Low / Median / High Price $40.74 / $154.88 / $239.88	Professional		$40.74	$154.88	$239.88
United Facility/Professional Facility Modifier Low / Median / High Price $28.84 / $34.67 / $46.77	Facility		$28.84	$34.67	$46.77
United Facility/Professional Professional Modifier Low / Median / High Price $19.50 / $31.62 / $95.50	Professional		$19.50	$31.62	$95.50