Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $89.13 / $169.82 / $208.93	Facility		$89.13	$169.82	$208.93
Aetna Facility/Professional Professional Modifier Low / Median / High Price $25.70 / $61.66 / $89.13	Professional		$25.70	$61.66	$89.13
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $162.18 / $204.17 / $208.93	Facility		$162.18	$204.17	$208.93
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $30.20 / $30.20 / $239.88	Professional		$30.20	$30.20	$239.88
CareSource Facility/Professional Facility Modifier Low / Median / High Price $39.81 / $39.81 / $39.81	Facility		$39.81	$39.81	$39.81
Cigna Facility/Professional Facility Modifier Low / Median / High Price $208.93 / $245.47 / $389.05	Facility		$208.93	$245.47	$389.05
Cigna Facility/Professional Professional Modifier Low / Median / High Price $87.10 / $109.65 / $234.42	Professional		$87.10	$109.65	$234.42
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $19.50 / $120.23 / $194.98	Facility		$19.50	$120.23	$194.98
DeanCare Facility/Professional Professional Modifier Low / Median / High Price $457.09 / $457.09 / $501.19	Professional		$457.09	$457.09	$501.19
Medica Facility/Professional Facility Modifier Low / Median / High Price $19.50 / $72.44 / $263.03	Facility		$19.50	$72.44	$263.03
Medica Facility/Professional Professional Modifier Low / Median / High Price $17.78 / $45.71 / $269.15	Professional		$17.78	$45.71	$269.15
Molina Facility/Professional Professional Modifier Low / Median / High Price $27.54 / $64.57 / $85.11	Professional		$27.54	$64.57	$85.11
Quartz Facility/Professional Professional Modifier Low / Median / High Price $57.54 / $177.83 / $251.19	Professional		$57.54	$177.83	$251.19
Quartz Facility/Professional Facility Modifier Low / Median / High Price $151.36 / $151.36 / $363.08	Facility		$151.36	$151.36	$363.08
Quartz Facility/Professional Professional Modifier Low / Median / High Price $35.48 / $380.19 / $380.19	Professional		$35.48	$380.19	$380.19
Security Health Facility/Professional Professional Modifier Low / Median / High Price $22.39 / $22.39 / $162.18	Professional		$22.39	$22.39	$162.18
Security Health Facility/Professional Professional Modifier Low / Median / High Price $22.39 / $87.10 / $416.87	Professional		$22.39	$87.10	$416.87
United Facility/Professional Facility Modifier Low / Median / High Price $38.02 / $60.26 / $91.20	Facility		$38.02	$60.26	$91.20
United Facility/Professional Professional Modifier Low / Median / High Price $17.78 / $45.71 / $91.20	Professional		$17.78	$45.71	$91.20