Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $93.33 / $213.80 / $707.95	Facility		$93.33	$213.80	$707.95
Aetna Facility/Professional Professional Modifier Low / Median / High Price $51.29 / $63.10 / $93.33	Professional		$51.29	$63.10	$93.33
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $165.96 / $208.93 / $213.80	Facility		$165.96	$208.93	$213.80
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $30.90 / $30.90 / $275.42	Professional		$30.90	$30.90	$275.42
CareSource Facility/Professional Facility Modifier Low / Median / High Price $54.95 / $54.95 / $54.95	Facility		$54.95	$54.95	$54.95
Cigna Facility/Professional Facility Modifier Low / Median / High Price $213.80 / $251.19 / $398.11	Facility		$213.80	$251.19	$398.11
Cigna Facility/Professional Professional Modifier Low / Median / High Price $89.13 / $112.20 / $245.47	Professional		$89.13	$112.20	$245.47
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $33.88 / $154.88 / $302.00	Facility		$33.88	$154.88	$302.00
Medica Facility/Professional Facility Modifier Low / Median / High Price $33.88 / $70.79 / $371.54	Facility		$33.88	$70.79	$371.54
Medica Facility/Professional Professional Modifier Low / Median / High Price $30.90 / $46.77 / $120.23	Professional		$30.90	$46.77	$120.23
Molina Facility/Professional Professional Modifier Low / Median / High Price $33.11 / $64.57 / $85.11	Professional		$33.11	$64.57	$85.11
Quartz Facility/Professional Professional Modifier Low / Median / High Price $100.00 / $181.97 / $257.04	Professional		$100.00	$181.97	$257.04
Quartz Facility/Professional Facility Modifier Low / Median / High Price $154.88 / $154.88 / $371.54	Facility		$154.88	$154.88	$371.54
Quartz Facility/Professional Professional Modifier Low / Median / High Price $24.55 / $25.12 / $34.67	Professional		$24.55	$25.12	$34.67
Security Health Facility/Professional Professional Modifier Low / Median / High Price $42.66 / $42.66 / $165.96	Professional		$42.66	$42.66	$165.96
Security Health Facility/Professional Professional Modifier Low / Median / High Price $42.66 / $128.82 / $426.58	Professional		$42.66	$128.82	$426.58
United Facility/Professional Facility Modifier Low / Median / High Price $38.90 / $61.66 / $93.33	Facility		$38.90	$61.66	$93.33
United Facility/Professional Professional Modifier Low / Median / High Price $30.90 / $46.77 / $141.25	Professional		$30.90	$46.77	$141.25