Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $41.69 / $169.82 / $380.19	Facility		$41.69	$169.82	$380.19
Aetna Facility/Professional Professional Modifier Low / Median / High Price $19.50 / $25.12 / $33.11	Professional		$19.50	$25.12	$33.11
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $60.26 / $75.86 / $77.62	Facility		$60.26	$75.86	$77.62
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $13.80 / $13.80 / $112.20	Professional		$13.80	$13.80	$112.20
CareSource Facility/Professional Facility Modifier Low / Median / High Price $19.05 / $77.62 / $79.43	Facility		$19.05	$77.62	$79.43
CareSource Facility/Professional Professional Modifier Low / Median / High Price $28.18 / $28.18 / $28.18	Professional		$28.18	$28.18	$28.18
Cigna Facility/Professional Facility Modifier Low / Median / High Price $77.62 / $91.20 / $144.54	Facility		$77.62	$91.20	$144.54
Cigna Facility/Professional Professional Modifier Low / Median / High Price $32.36 / $39.81 / $87.10	Professional		$32.36	$39.81	$87.10
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $25.12 / $61.66 / $223.87	Facility		$25.12	$61.66	$223.87
Medica Facility/Professional Facility Modifier Low / Median / High Price $22.39 / $33.88 / $245.47	Facility		$22.39	$33.88	$245.47
Medica Facility/Professional Professional Modifier Low / Median / High Price $16.60 / $22.91 / $69.18	Professional		$16.60	$22.91	$69.18
Molina Facility/Professional Professional Modifier Low / Median / High Price $28.18 / $54.95 / $100.00	Professional		$28.18	$54.95	$100.00
Quartz Facility/Professional Professional Modifier Low / Median / High Price $36.31 / $72.44 / $218.78	Professional		$36.31	$72.44	$218.78
Quartz Facility/Professional Facility Modifier Low / Median / High Price $56.23 / $56.23 / $138.04	Facility		$56.23	$56.23	$138.04
Quartz Facility/Professional Professional Modifier Low / Median / High Price $14.79 / $18.62 / $27.54	Professional		$14.79	$18.62	$27.54
Security Health Facility/Professional Professional Modifier Low / Median / High Price $60.26 / $60.26 / $81.28	Professional		$60.26	$60.26	$81.28
Security Health Facility/Professional Professional Modifier Low / Median / High Price $81.28 / $112.20 / $173.78	Professional		$81.28	$112.20	$173.78
United Facility/Professional Facility Modifier Low / Median / High Price $21.38 / $25.12 / $33.88	Facility		$21.38	$25.12	$33.88
United Facility/Professional Professional Modifier Low / Median / High Price $14.13 / $22.91 / $69.18	Professional		$14.13	$22.91	$69.18