Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $100.00 / $245.47 / $354.81	Facility		$100.00	$245.47	$354.81
Aetna Facility/Professional Professional Modifier Low / Median / High Price $52.48 / $61.66 / $186.21	Professional		$52.48	$61.66	$186.21
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $144.54 / $181.97 / $186.21	Facility		$144.54	$181.97	$186.21
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $33.11 / $33.11 / $269.15	Professional		$33.11	$33.11	$269.15
CareSource Facility/Professional Facility Modifier Low / Median / High Price $45.71 / $186.21 / $190.55	Facility		$45.71	$186.21	$190.55
CareSource Facility/Professional Professional Modifier Low / Median / High Price $67.61 / $67.61 / $67.61	Professional		$67.61	$67.61	$67.61
Cigna Facility/Professional Facility Modifier Low / Median / High Price $186.21 / $218.78 / $346.74	Facility		$186.21	$218.78	$346.74
Cigna Facility/Professional Professional Modifier Low / Median / High Price $77.62 / $95.50 / $208.93	Professional		$77.62	$95.50	$208.93
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $60.26 / $147.91 / $537.03	Facility		$60.26	$147.91	$537.03
Medica Facility/Professional Facility Modifier Low / Median / High Price $53.70 / $67.61 / $323.59	Facility		$53.70	$67.61	$323.59
Medica Facility/Professional Professional Modifier Low / Median / High Price $40.74 / $56.23 / $151.36	Professional		$40.74	$56.23	$151.36
Molina Facility/Professional Professional Modifier Low / Median / High Price $33.11 / $67.61 / $186.21	Professional		$33.11	$67.61	$186.21
Quartz Facility/Professional Professional Modifier Low / Median / High Price $87.10 / $169.82 / $275.42	Professional		$87.10	$169.82	$275.42
Quartz Facility/Professional Facility Modifier Low / Median / High Price $134.90 / $134.90 / $323.59	Facility		$134.90	$134.90	$323.59
Quartz Facility/Professional Professional Modifier Low / Median / High Price $35.48 / $44.67 / $66.07	Professional		$35.48	$44.67	$66.07
Security Health Facility/Professional Professional Modifier Low / Median / High Price $144.54 / $144.54 / $223.87	Professional		$144.54	$144.54	$223.87
Security Health Facility/Professional Professional Modifier Low / Median / High Price $223.87 / $223.87 / $371.54	Professional		$223.87	$223.87	$371.54
United Facility/Professional Facility Modifier Low / Median / High Price $51.29 / $60.26 / $81.28	Facility		$51.29	$60.26	$81.28
United Facility/Professional Professional Modifier Low / Median / High Price $33.88 / $54.95 / $151.36	Professional		$33.88	$54.95	$151.36