Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $28.84 / $69.18 / $165.96	Facility		$28.84	$69.18	$165.96
Aetna Facility/Professional Professional Modifier Low / Median / High Price $18.62 / $21.88 / $25.12	Professional		$18.62	$21.88	$25.12
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $53.70 / $67.61 / $69.18	Facility		$53.70	$67.61	$69.18
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $18.20 / $18.62 / $100.00	Professional		$18.20	$18.62	$100.00
CareSource Facility/Professional Facility Modifier Low / Median / High Price $16.60 / $69.18 / $70.79	Facility		$16.60	$69.18	$70.79
CareSource Facility/Professional Professional Modifier Low / Median / High Price $25.12 / $25.12 / $25.12	Professional		$25.12	$25.12	$25.12
Cigna Facility/Professional Facility Modifier Low / Median / High Price $69.18 / $79.43 / $128.82	Facility		$69.18	$79.43	$128.82
Cigna Facility/Professional Professional Modifier Low / Median / High Price $28.18 / $35.48 / $77.62	Professional		$28.18	$35.48	$77.62
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $22.39 / $54.95 / $199.53	Facility		$22.39	$54.95	$199.53
Medica Facility/Professional Facility Modifier Low / Median / High Price $19.50 / $23.44 / $141.25	Facility		$19.50	$23.44	$141.25
Medica Facility/Professional Professional Modifier Low / Median / High Price $15.14 / $20.42 / $56.23	Professional		$15.14	$20.42	$56.23
Molina Facility/Professional Professional Modifier Low / Median / High Price $25.12 / $37.15 / $85.11	Professional		$25.12	$37.15	$85.11
Quartz Facility/Professional Professional Modifier Low / Median / High Price $32.36 / $63.10 / $295.12	Professional		$32.36	$63.10	$295.12
Quartz Facility/Professional Facility Modifier Low / Median / High Price $50.12 / $50.12 / $141.25	Facility		$50.12	$50.12	$141.25
Quartz Facility/Professional Professional Modifier Low / Median / High Price $13.18 / $16.60 / $24.55	Professional		$13.18	$16.60	$24.55
Security Health Facility/Professional Professional Modifier Low / Median / High Price $47.86 / $47.86 / $53.70	Professional		$47.86	$47.86	$53.70
Security Health Facility/Professional Professional Modifier Low / Median / High Price $47.86 / $47.86 / $151.36	Professional		$47.86	$47.86	$151.36
United Facility/Professional Facility Modifier Low / Median / High Price $18.62 / $22.39 / $30.20	Facility		$18.62	$22.39	$30.20
United Facility/Professional Professional Modifier Low / Median / High Price $12.59 / $19.95 / $61.66	Professional		$12.59	$19.95	$61.66