Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $89.19 / $247.27 / $360.99	Facility		$89.19	$247.27	$360.99
Aetna Facility/Professional Professional Modifier Low / Median / High Price $30.25 / $30.78 / $58.50	Professional		$30.25	$30.78	$58.50
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $84.41 / $102.08 / $107.97	Facility		$84.41	$102.08	$107.97
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $25.14 / $25.14 / $160.15	Professional		$25.14	$25.14	$160.15
CareSource Facility/Professional Facility Modifier Low / Median / High Price $26.55 / $95.95 / $99.72	Facility		$26.55	$95.95	$99.72
CareSource Facility/Professional Professional Modifier Low / Median / High Price $39.26 / $39.26 / $39.26	Professional		$39.26	$39.26	$39.26
Cigna Facility/Professional Facility Modifier Low / Median / High Price $108.13 / $126.36 / $193.85	Facility		$108.13	$126.36	$193.85
Cigna Facility/Professional Professional Modifier Low / Median / High Price $45.02 / $105.72 / $120.14	Professional		$45.02	$105.72	$120.14
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $30.23 / $31.41 / $47.11	Facility		$30.23	$31.41	$47.11
Medica Facility/Professional Facility Modifier Low / Median / High Price $30.23 / $186.49 / $325.27	Facility		$30.23	$186.49	$325.27
Medica Facility/Professional Professional Modifier Low / Median / High Price $23.56 / $39.26 / $129.21	Professional		$23.56	$39.26	$129.21
Molina Facility/Professional Professional Modifier Low / Median / High Price $19.63 / $55.00 / $85.00	Professional		$19.63	$55.00	$85.00
Prevea360 Facility/Professional Facility Modifier Low / Median / High Price $30.23 / $31.41 / $47.11	Facility		$30.23	$31.41	$47.11
Quartz Facility/Professional Professional Modifier Low / Median / High Price $45.98 / $95.83 / $133.10	Professional		$45.98	$95.83	$133.10
Quartz Facility/Professional Facility Modifier Low / Median / High Price $78.52 / $78.52 / $186.49	Facility		$78.52	$78.52	$186.49
Quartz Facility/Professional Professional Modifier Low / Median / High Price $20.81 / $22.37 / $33.19	Professional		$20.81	$22.37	$33.19
Security Health Facility/Professional Professional Modifier Low / Median / High Price $66.95 / $66.95 / $83.61	Professional		$66.95	$66.95	$83.61
Security Health Facility/Professional Professional Modifier Low / Median / High Price $66.95 / $66.95 / $214.36	Professional		$66.95	$66.95	$214.36
United Facility/Professional Facility Modifier Low / Median / High Price $47.11 / $47.11 / $47.11	Facility		$47.11	$47.11	$47.11
United Facility/Professional Professional Modifier Low / Median / High Price $21.20 / $31.41 / $99.60	Professional		$21.20	$31.41	$99.60