Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $56.23 / $269.15 / $489.78	Facility		$56.23	$269.15	$489.78
Aetna Facility/Professional Professional Modifier Low / Median / High Price $19.95 / $66.07 / $154.88	Professional		$19.95	$66.07	$154.88
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $54.95 / $69.18 / $69.18	Facility		$54.95	$69.18	$69.18
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $12.59 / $12.59 / $74.13	Professional		$12.59	$12.59	$74.13
CareSource Facility/Professional Facility Modifier Low / Median / High Price $16.98 / $70.79 / $72.44	Facility		$16.98	$70.79	$72.44
CareSource Facility/Professional Professional Modifier Low / Median / High Price $25.70 / $25.70 / $25.70	Professional		$25.70	$25.70	$25.70
Cigna Facility/Professional Facility Modifier Low / Median / High Price $70.79 / $81.28 / $131.83	Facility		$70.79	$81.28	$131.83
Cigna Facility/Professional Professional Modifier Low / Median / High Price $29.51 / $36.31 / $79.43	Professional		$29.51	$36.31	$79.43
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $22.91 / $31.62 / $50.12	Facility		$22.91	$31.62	$50.12
Medica Facility/Professional Facility Modifier Low / Median / High Price $20.89 / $30.20 / $141.25	Facility		$20.89	$30.20	$141.25
Medica Facility/Professional Professional Modifier Low / Median / High Price $4.79 / $15.14 / $47.86	Professional		$4.79	$15.14	$47.86
Molina Facility/Professional Professional Modifier Low / Median / High Price $11.48 / $21.88 / $64.57	Professional		$11.48	$21.88	$64.57
Quartz Facility/Professional Professional Modifier Low / Median / High Price $32.36 / $64.57 / $120.23	Professional		$32.36	$64.57	$120.23
Quartz Facility/Professional Facility Modifier Low / Median / High Price $60.26 / $60.26 / $141.25	Facility		$60.26	$60.26	$141.25
Quartz Facility/Professional Professional Modifier Low / Median / High Price $13.49 / $16.98 / $24.55	Professional		$13.49	$16.98	$24.55
Security Health Facility/Professional Professional Modifier Low / Median / High Price $25.70 / $25.70 / $53.70	Professional		$25.70	$25.70	$53.70
Security Health Facility/Professional Professional Modifier Low / Median / High Price $25.70 / $74.13 / $141.25	Professional		$25.70	$74.13	$141.25
United Facility/Professional Facility Modifier Low / Median / High Price $19.05 / $22.39 / $30.20	Facility		$19.05	$22.39	$30.20
United Facility/Professional Professional Modifier Low / Median / High Price $4.79 / $15.14 / $48.98	Professional		$4.79	$15.14	$48.98