Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $52.48 / $173.78 / $218.78	Facility		$52.48	$173.78	$218.78
Aetna Facility/Professional Professional Modifier Low / Median / High Price $28.18 / $33.88 / $87.10	Professional		$28.18	$33.88	$87.10
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $81.28 / $102.33 / $104.71	Facility		$81.28	$102.33	$104.71
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $18.62 / $18.62 / $151.36	Professional		$18.62	$18.62	$151.36
CareSource Facility/Professional Facility Modifier Low / Median / High Price $30.20 / $104.71 / $107.15	Facility		$30.20	$104.71	$107.15
CareSource Facility/Professional Professional Modifier Low / Median / High Price $38.02 / $38.02 / $38.02	Professional		$38.02	$38.02	$38.02
Cigna Facility/Professional Facility Modifier Low / Median / High Price $104.71 / $120.23 / $194.98	Facility		$104.71	$120.23	$194.98
Cigna Facility/Professional Professional Modifier Low / Median / High Price $43.65 / $53.70 / $117.49	Professional		$43.65	$53.70	$117.49
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $33.88 / $83.18 / $302.00	Facility		$33.88	$83.18	$302.00
Medica Facility/Professional Facility Modifier Low / Median / High Price $29.51 / $35.48 / $109.65	Facility		$29.51	$35.48	$109.65
Medica Facility/Professional Professional Modifier Low / Median / High Price $21.88 / $30.90 / $85.11	Professional		$21.88	$30.90	$85.11
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.36 / $54.95 / $131.83	Professional		$32.36	$54.95	$131.83
Quartz Facility/Professional Professional Modifier Low / Median / High Price $48.98 / $95.50 / $147.91	Professional		$48.98	$95.50	$147.91
Quartz Facility/Professional Facility Modifier Low / Median / High Price $89.13 / $89.13 / $186.21	Facility		$89.13	$89.13	$186.21
Quartz Facility/Professional Professional Modifier Low / Median / High Price $19.95 / $24.55 / $37.15	Professional		$19.95	$24.55	$37.15
Security Health Facility/Professional Professional Modifier Low / Median / High Price $57.54 / $57.54 / $79.43	Professional		$57.54	$57.54	$79.43
Security Health Facility/Professional Professional Modifier Low / Median / High Price $57.54 / $109.65 / $208.93	Professional		$57.54	$109.65	$208.93
United Facility/Professional Facility Modifier Low / Median / High Price $28.18 / $33.88 / $45.71	Facility		$28.18	$33.88	$45.71
United Facility/Professional Professional Modifier Low / Median / High Price $19.05 / $30.90 / $89.13	Professional		$19.05	$30.90	$89.13