Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $30.90 / $147.91 / $275.42	Facility		$30.90	$147.91	$275.42
Aetna Facility/Professional Professional Modifier Low / Median / High Price $10.00 / $12.30 / $54.95	Professional		$10.00	$12.30	$54.95
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $29.51 / $37.15 / $38.02	Facility		$29.51	$37.15	$38.02
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $6.76 / $6.76 / $54.95	Professional		$6.76	$6.76	$54.95
CareSource Facility/Professional Facility Modifier Low / Median / High Price $9.33 / $38.90 / $38.90	Facility		$9.33	$38.90	$38.90
CareSource Facility/Professional Professional Modifier Low / Median / High Price $13.80 / $13.80 / $13.80	Professional		$13.80	$13.80	$13.80
Cigna Facility/Professional Facility Modifier Low / Median / High Price $38.02 / $44.67 / $70.79	Facility		$38.02	$44.67	$70.79
Cigna Facility/Professional Professional Modifier Low / Median / High Price $16.22 / $19.95 / $43.65	Professional		$16.22	$19.95	$43.65
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $12.30 / $30.20 / $109.65	Facility		$12.30	$30.20	$109.65
Medica Facility/Professional Facility Modifier Low / Median / High Price $10.96 / $14.13 / $213.80	Facility		$10.96	$14.13	$213.80
Medica Facility/Professional Professional Modifier Low / Median / High Price $8.13 / $11.48 / $33.88	Professional		$8.13	$11.48	$33.88
Molina Facility/Professional Professional Modifier Low / Median / High Price $13.80 / $33.11 / $85.11	Professional		$13.80	$33.11	$85.11
Quartz Facility/Professional Professional Modifier Low / Median / High Price $17.78 / $35.48 / $275.42	Professional		$17.78	$35.48	$275.42
Quartz Facility/Professional Facility Modifier Low / Median / High Price $27.54 / $27.54 / $213.80	Facility		$27.54	$27.54	$213.80
Quartz Facility/Professional Professional Modifier Low / Median / High Price $7.41 / $9.12 / $13.49	Professional		$7.41	$9.12	$13.49
Security Health Facility/Professional Professional Modifier Low / Median / High Price $29.51 / $29.51 / $134.90	Professional		$29.51	$29.51	$134.90
Security Health Facility/Professional Professional Modifier Low / Median / High Price $54.95 / $97.72 / $134.90	Professional		$54.95	$97.72	$134.90
United Facility/Professional Facility Modifier Low / Median / High Price $10.47 / $12.30 / $16.60	Facility		$10.47	$12.30	$16.60
United Facility/Professional Professional Modifier Low / Median / High Price $5.75 / $11.22 / $33.88	Professional		$5.75	$11.22	$33.88