Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $44.67 / $100.00 / $114.82	Facility		$44.67	$100.00	$114.82
Aetna Facility/Professional Professional Modifier Low / Median / High Price $15.85 / $21.38 / $79.43	Professional		$15.85	$21.38	$79.43
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $42.66 / $53.70 / $54.95	Facility		$42.66	$53.70	$54.95
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $10.00 / $10.00 / $83.18	Professional		$10.00	$10.00	$83.18
CareSource Facility/Professional Facility Modifier Low / Median / High Price $19.95 / $30.20 / $56.23	Facility		$19.95	$30.20	$56.23
CareSource Facility/Professional Professional Modifier Low / Median / High Price $19.95 / $21.88 / $28.18	Professional		$19.95	$21.88	$28.18
Cigna Facility/Professional Facility Modifier Low / Median / High Price $54.95 / $64.57 / $102.33	Facility		$54.95	$64.57	$102.33
Cigna Facility/Professional Professional Modifier Low / Median / High Price $22.91 / $47.86 / $63.10	Professional		$22.91	$47.86	$63.10
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $23.99 / $100.00 / $158.49	Facility		$23.99	$100.00	$158.49
DeanCare Facility/Professional Professional Modifier Low / Median / High Price $120.23 / $120.23 / $134.90	Professional		$120.23	$120.23	$134.90
Medica Facility/Professional Facility Modifier Low / Median / High Price $19.05 / $27.54 / $95.50	Facility		$19.05	$27.54	$95.50
Medica Facility/Professional Professional Modifier Low / Median / High Price $12.02 / $22.91 / $100.00	Professional		$12.02	$22.91	$100.00
Molina Facility/Professional Professional Modifier Low / Median / High Price $19.95 / $54.95 / $70.79	Professional		$19.95	$54.95	$70.79
Quartz Facility/Professional Professional Modifier Low / Median / High Price $34.67 / $51.29 / $85.11	Professional		$34.67	$51.29	$85.11
Quartz Facility/Professional Facility Modifier Low / Median / High Price $42.66 / $95.50 / $95.50	Facility		$42.66	$95.50	$95.50
Quartz Facility/Professional Professional Modifier Low / Median / High Price $23.99 / $112.20 / $165.96	Professional		$23.99	$112.20	$165.96
Security Health Facility/Professional Professional Modifier Low / Median / High Price $42.66 / $42.66 / $69.18	Professional		$42.66	$42.66	$69.18
Security Health Facility/Professional Professional Modifier Low / Median / High Price $69.18 / $79.43 / $123.03	Professional		$69.18	$79.43	$123.03
United Facility/Professional Facility Modifier Low / Median / High Price $17.78 / $17.78 / $23.99	Facility		$17.78	$17.78	$23.99
United Facility/Professional Professional Modifier Low / Median / High Price $8.51 / $16.22 / $42.66	Professional		$8.51	$16.22	$42.66