Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $54.95 / $102.33 / $125.89	Facility		$54.95	$102.33	$125.89
Aetna Facility/Professional Professional Modifier Low / Median / High Price $30.20 / $37.15 / $54.95	Professional		$30.20	$37.15	$54.95
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $100.00 / $125.89 / $125.89	Facility		$100.00	$125.89	$125.89
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $18.62 / $18.62 / $162.18	Professional		$18.62	$18.62	$162.18
CareSource Facility/Professional Facility Modifier Low / Median / High Price $29.51 / $114.82 / $117.49	Facility		$29.51	$114.82	$117.49
CareSource Facility/Professional Professional Modifier Low / Median / High Price $46.77 / $46.77 / $46.77	Professional		$46.77	$46.77	$46.77
Cigna Facility/Professional Facility Modifier Low / Median / High Price $125.89 / $147.91 / $234.42	Facility		$125.89	$147.91	$234.42
Cigna Facility/Professional Professional Modifier Low / Median / High Price $53.70 / $66.07 / $144.54	Professional		$53.70	$66.07	$144.54
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $33.88 / $93.33 / $269.15	Facility		$33.88	$93.33	$269.15
Medica Facility/Professional Facility Modifier Low / Median / High Price $33.88 / $41.69 / $218.78	Facility		$33.88	$41.69	$218.78
Medica Facility/Professional Professional Modifier Low / Median / High Price $22.91 / $28.18 / $83.18	Professional		$22.91	$28.18	$83.18
Molina Facility/Professional Professional Modifier Low / Median / High Price $22.91 / $46.77 / $85.11	Professional		$22.91	$46.77	$85.11
Quartz Facility/Professional Professional Modifier Low / Median / High Price $60.26 / $109.65 / $151.36	Professional		$60.26	$109.65	$151.36
Quartz Facility/Professional Facility Modifier Low / Median / High Price $93.33 / $93.33 / $218.78	Facility		$93.33	$93.33	$218.78
Quartz Facility/Professional Professional Modifier Low / Median / High Price $22.39 / $22.39 / $22.91	Professional		$22.39	$22.39	$22.91
Security Health Facility/Professional Professional Modifier Low / Median / High Price $97.72 / $97.72 / $169.82	Professional		$97.72	$97.72	$169.82
Security Health Facility/Professional Professional Modifier Low / Median / High Price $134.90 / $169.82 / $251.19	Professional		$134.90	$169.82	$251.19
United Facility/Professional Facility Modifier Low / Median / High Price $25.70 / $37.15 / $54.95	Facility		$25.70	$37.15	$54.95
United Facility/Professional Professional Modifier Low / Median / High Price $19.95 / $28.18 / $89.13	Professional		$19.95	$28.18	$89.13