Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $28.18 / $66.07 / $109.65	Facility		$28.18	$66.07	$109.65
Aetna Facility/Professional Professional Modifier Low / Median / High Price $15.85 / $19.95 / $33.88	Professional		$15.85	$19.95	$33.88
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $51.29 / $64.57 / $66.07	Facility		$51.29	$64.57	$66.07
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $9.55 / $9.55 / $85.11	Professional		$9.55	$9.55	$85.11
CareSource Facility/Professional Facility Modifier Low / Median / High Price $17.78 / $60.26 / $61.66	Facility		$17.78	$60.26	$61.66
CareSource Facility/Professional Professional Modifier Low / Median / High Price $23.99 / $23.99 / $23.99	Professional		$23.99	$23.99	$23.99
Cigna Facility/Professional Facility Modifier Low / Median / High Price $66.07 / $77.62 / $123.03	Facility		$66.07	$77.62	$123.03
Cigna Facility/Professional Professional Modifier Low / Median / High Price $27.54 / $34.67 / $75.86	Professional		$27.54	$34.67	$75.86
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $15.85 / $47.86 / $141.25	Facility		$15.85	$47.86	$141.25
Medica Facility/Professional Facility Modifier Low / Median / High Price $15.85 / $21.88 / $114.82	Facility		$15.85	$21.88	$114.82
Medica Facility/Professional Professional Modifier Low / Median / High Price $12.02 / $14.79 / $43.65	Professional		$12.02	$14.79	$43.65
Molina Facility/Professional Professional Modifier Low / Median / High Price $23.99 / $36.31 / $66.07	Professional		$23.99	$36.31	$66.07
Quartz Facility/Professional Professional Modifier Low / Median / High Price $30.90 / $61.66 / $79.43	Professional		$30.90	$61.66	$79.43
Quartz Facility/Professional Facility Modifier Low / Median / High Price $47.86 / $47.86 / $114.82	Facility		$47.86	$47.86	$114.82
Quartz Facility/Professional Professional Modifier Low / Median / High Price $11.48 / $11.75 / $17.38	Professional		$11.48	$11.75	$17.38
Security Health Facility/Professional Professional Modifier Low / Median / High Price $51.29 / $51.29 / $204.17	Professional		$51.29	$51.29	$204.17
Security Health Facility/Professional Professional Modifier Low / Median / High Price $72.44 / $169.82 / $204.17	Professional		$72.44	$169.82	$204.17
United Facility/Professional Facility Modifier Low / Median / High Price $13.18 / $19.05 / $28.84	Facility		$13.18	$19.05	$28.84
United Facility/Professional Professional Modifier Low / Median / High Price $10.00 / $14.45 / $46.77	Professional		$10.00	$14.45	$46.77