Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $40.74 / $93.33 / $263.03	Facility		$40.74	$93.33	$263.03
Aetna Facility/Professional Professional Modifier Low / Median / High Price $25.12 / $28.84 / $51.29	Professional		$25.12	$28.84	$51.29
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $74.13 / $91.20 / $93.33	Facility		$74.13	$91.20	$93.33
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $15.49 / $15.49 / $138.04	Professional		$15.49	$15.49	$138.04
CareSource Facility/Professional Facility Modifier Low / Median / High Price $22.91 / $87.10 / $89.13	Facility		$22.91	$87.10	$89.13
CareSource Facility/Professional Professional Modifier Low / Median / High Price $33.88 / $33.88 / $33.88	Professional		$33.88	$33.88	$33.88
Cigna Facility/Professional Facility Modifier Low / Median / High Price $93.33 / $109.65 / $173.78	Facility		$93.33	$109.65	$173.78
Cigna Facility/Professional Professional Modifier Low / Median / High Price $38.90 / $48.98 / $107.15	Professional		$38.90	$48.98	$107.15
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $28.18 / $69.18 / $251.19	Facility		$28.18	$69.18	$251.19
Medica Facility/Professional Facility Modifier Low / Median / High Price $26.92 / $30.90 / $162.18	Facility		$26.92	$30.90	$162.18
Medica Facility/Professional Professional Modifier Low / Median / High Price $19.50 / $26.30 / $70.79	Professional		$19.50	$26.30	$70.79
Molina Facility/Professional Professional Modifier Low / Median / High Price $16.98 / $33.88 / $85.11	Professional		$16.98	$33.88	$85.11
Quartz Facility/Professional Professional Modifier Low / Median / High Price $43.65 / $87.10 / $120.23	Professional		$43.65	$87.10	$120.23
Quartz Facility/Professional Facility Modifier Low / Median / High Price $67.61 / $67.61 / $162.18	Facility		$67.61	$67.61	$162.18
Quartz Facility/Professional Professional Modifier Low / Median / High Price $20.89 / $20.89 / $28.84	Professional		$20.89	$20.89	$28.84
Security Health Facility/Professional Professional Modifier Low / Median / High Price $72.44 / $72.44 / $97.72	Professional		$72.44	$72.44	$97.72
Security Health Facility/Professional Professional Modifier Low / Median / High Price $97.72 / $112.20 / $208.93	Professional		$97.72	$112.20	$208.93
United Facility/Professional Facility Modifier Low / Median / High Price $23.99 / $28.18 / $40.74	Facility		$23.99	$28.18	$40.74
United Facility/Professional Professional Modifier Low / Median / High Price $16.98 / $26.30 / $75.86	Professional		$16.98	$26.30	$75.86