Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $70.79 / $239.88 / $309.03	Facility		$70.79	$239.88	$309.03
Aetna Facility/Professional Professional Modifier Low / Median / High Price $36.31 / $42.66 / $125.89	Professional		$36.31	$42.66	$125.89
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $100.00 / $125.89 / $128.82	Facility		$100.00	$125.89	$128.82
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $23.44 / $23.44 / $186.21	Professional		$23.44	$23.44	$186.21
CareSource Facility/Professional Facility Modifier Low / Median / High Price $38.02 / $131.83 / $131.83	Facility		$38.02	$131.83	$131.83
CareSource Facility/Professional Professional Modifier Low / Median / High Price $46.77 / $46.77 / $46.77	Professional		$46.77	$46.77	$46.77
Cigna Facility/Professional Facility Modifier Low / Median / High Price $128.82 / $151.36 / $239.88	Facility		$128.82	$151.36	$239.88
Cigna Facility/Professional Professional Modifier Low / Median / High Price $53.70 / $67.61 / $147.91	Professional		$53.70	$67.61	$147.91
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $41.69 / $102.33 / $371.54	Facility		$41.69	$102.33	$371.54
Medica Facility/Professional Facility Modifier Low / Median / High Price $37.15 / $44.67 / $169.82	Facility		$37.15	$44.67	$169.82
Medica Facility/Professional Professional Modifier Low / Median / High Price $28.18 / $38.90 / $107.15	Professional		$28.18	$38.90	$107.15
Molina Facility/Professional Professional Modifier Low / Median / High Price $23.44 / $54.95 / $91.20	Professional		$23.44	$54.95	$91.20
Quartz Facility/Professional Professional Modifier Low / Median / High Price $60.26 / $120.23 / $295.12	Professional		$60.26	$120.23	$295.12
Quartz Facility/Professional Facility Modifier Low / Median / High Price $112.20 / $112.20 / $223.87	Facility		$112.20	$112.20	$223.87
Quartz Facility/Professional Professional Modifier Low / Median / High Price $25.12 / $30.90 / $45.71	Professional		$25.12	$30.90	$45.71
Security Health Facility/Professional Professional Modifier Low / Median / High Price $93.33 / $93.33 / $100.00	Professional		$93.33	$93.33	$100.00
Security Health Facility/Professional Professional Modifier Low / Median / High Price $93.33 / $138.04 / $257.04	Professional		$93.33	$138.04	$257.04
United Facility/Professional Facility Modifier Low / Median / High Price $35.48 / $41.69 / $56.23	Facility		$35.48	$41.69	$56.23
United Facility/Professional Professional Modifier Low / Median / High Price $23.44 / $38.02 / $117.49	Professional		$23.44	$38.02	$117.49