Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $69.18 / $223.87 / $512.86	Facility		$69.18	$223.87	$512.86
Aetna Facility/Professional Professional Modifier Low / Median / High Price $30.20 / $35.48 / $85.11	Professional		$30.20	$35.48	$85.11
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $87.10 / $109.65 / $112.20	Facility		$87.10	$109.65	$112.20
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $19.95 / $19.95 / $162.18	Professional		$19.95	$19.95	$162.18
CareSource Facility/Professional Facility Modifier Low / Median / High Price $26.92 / $112.20 / $114.82	Facility		$26.92	$112.20	$114.82
CareSource Facility/Professional Professional Modifier Low / Median / High Price $40.74 / $40.74 / $40.74	Professional		$40.74	$40.74	$40.74
Cigna Facility/Professional Facility Modifier Low / Median / High Price $112.20 / $131.83 / $208.93	Facility		$112.20	$131.83	$208.93
Cigna Facility/Professional Professional Modifier Low / Median / High Price $46.77 / $58.88 / $125.89	Professional		$46.77	$58.88	$125.89
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $36.31 / $89.13 / $323.59	Facility		$36.31	$89.13	$323.59
Medica Facility/Professional Facility Modifier Low / Median / High Price $32.36 / $48.98 / $194.98	Facility		$32.36	$48.98	$194.98
Medica Facility/Professional Professional Modifier Low / Median / High Price $23.99 / $33.88 / $100.00	Professional		$23.99	$33.88	$100.00
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.36 / $54.95 / $112.20	Professional		$32.36	$54.95	$112.20
Quartz Facility/Professional Professional Modifier Low / Median / High Price $52.48 / $104.71 / $316.23	Professional		$52.48	$104.71	$316.23
Quartz Facility/Professional Facility Modifier Low / Median / High Price $81.28 / $81.28 / $194.98	Facility		$81.28	$81.28	$194.98
Quartz Facility/Professional Professional Modifier Low / Median / High Price $21.38 / $26.92 / $39.81	Professional		$21.38	$26.92	$39.81
Security Health Facility/Professional Professional Modifier Low / Median / High Price $87.10 / $87.10 / $87.10	Professional		$87.10	$87.10	$87.10
Security Health Facility/Professional Professional Modifier Low / Median / High Price $87.10 / $169.82 / $251.19	Professional		$87.10	$169.82	$251.19
United Facility/Professional Facility Modifier Low / Median / High Price $30.90 / $36.31 / $48.98	Facility		$30.90	$36.31	$48.98
United Facility/Professional Professional Modifier Low / Median / High Price $20.42 / $33.11 / $100.00	Professional		$20.42	$33.11	$100.00