Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $104.71 / $162.18 / $245.47	Facility		$104.71	$162.18	$245.47
Aetna Facility/Professional Professional Modifier Low / Median / High Price $61.66 / $74.13 / $147.91	Professional		$61.66	$74.13	$147.91
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $28.18 / $28.18 / $144.54	Professional		$28.18	$28.18	$144.54
CareSource Facility/Professional Facility Modifier Low / Median / High Price $70.79 / $104.71 / $177.83	Facility		$70.79	$104.71	$177.83
CareSource Facility/Professional Professional Modifier Low / Median / High Price $70.79 / $77.62 / $97.72	Professional		$70.79	$77.62	$97.72
Cigna Facility/Professional Facility Modifier Low / Median / High Price $158.49 / $208.93 / $302.00	Facility		$158.49	$208.93	$302.00
Cigna Facility/Professional Professional Modifier Low / Median / High Price $81.28 / $141.25 / $218.78	Professional		$81.28	$141.25	$218.78
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $74.13 / $144.54 / $208.93	Facility		$74.13	$144.54	$208.93
DeanCare Facility/Professional Professional Modifier Low / Median / High Price $416.87 / $416.87 / $467.74	Professional		$416.87	$416.87	$467.74
Medica Facility/Professional Facility Modifier Low / Median / High Price $74.13 / $85.11 / $245.47	Facility		$74.13	$85.11	$245.47
Medica Facility/Professional Professional Modifier Low / Median / High Price $35.48 / $46.77 / $346.74	Professional		$35.48	$46.77	$346.74
Molina Facility/Professional Professional Modifier Low / Median / High Price $50.12 / $58.88 / $85.11	Professional		$50.12	$58.88	$85.11
Quartz Facility/Professional Professional Modifier Low / Median / High Price $112.20 / $165.96 / $229.09	Professional		$112.20	$165.96	$229.09
Quartz Facility/Professional Facility Modifier Low / Median / High Price $141.25 / $331.13 / $331.13	Facility		$141.25	$331.13	$331.13
Quartz Facility/Professional Professional Modifier Low / Median / High Price $74.13 / $346.74 / $346.74	Professional		$74.13	$346.74	$346.74
Security Health Facility/Professional Professional Modifier Low / Median / High Price $30.90 / $30.90 / $66.07	Professional		$30.90	$30.90	$66.07
Security Health Facility/Professional Facility Modifier Low / Median / High Price $75.86 / $75.86 / $75.86	Facility		$75.86	$75.86	$75.86
Security Health Facility/Professional Professional Modifier Low / Median / High Price $30.90 / $30.90 / $380.19	Professional		$30.90	$30.90	$380.19
United Facility/Professional Facility Modifier Low / Median / High Price $58.88 / $58.88 / $85.11	Facility		$58.88	$58.88	$85.11
United Facility/Professional Professional Modifier Low / Median / High Price $31.62 / $46.77 / $123.03	Professional		$31.62	$46.77	$123.03