Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $53.70 / $218.78 / $436.52	Facility		$53.70	$218.78	$436.52
Aetna Facility/Professional Professional Modifier Low / Median / High Price $28.84 / $33.88 / $85.11	Professional		$28.84	$33.88	$85.11
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $83.18 / $104.71 / $104.71	Facility		$83.18	$104.71	$104.71
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 $26.30 / $107.15 / $109.65	Facility		$26.30	$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 / $83.18 / $309.03	Facility		$34.67	$83.18	$309.03
Medica Facility/Professional Facility Modifier Low / Median / High Price $30.20 / $37.15 / $181.97	Facility		$30.20	$37.15	$181.97
Medica Facility/Professional Professional Modifier Low / Median / High Price $22.91 / $32.36 / $87.10	Professional		$22.91	$32.36	$87.10
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.36 / $54.95 / $85.11	Professional		$32.36	$54.95	$85.11
Quartz Facility/Professional Professional Modifier Low / Median / High Price $48.98 / $97.72 / $186.21	Professional		$48.98	$97.72	$186.21
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 $56.23 / $56.23 / $81.28	Professional		$56.23	$56.23	$81.28
Security Health Facility/Professional Professional Modifier Low / Median / High Price $56.23 / $112.20 / $213.80	Professional		$56.23	$112.20	$213.80
United Facility/Professional Facility Modifier Low / Median / High Price $28.84 / $33.88 / $45.71	Facility		$28.84	$33.88	$45.71
United Facility/Professional Professional Modifier Low / Median / High Price $19.05 / $31.62 / $93.33	Professional		$19.05	$31.62	$93.33