Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $41.69 / $77.62 / $95.50	Facility		$41.69	$77.62	$95.50
Aetna Facility/Professional Professional Modifier Low / Median / High Price $22.91 / $31.62 / $70.79	Professional		$22.91	$31.62	$70.79
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $75.86 / $93.33 / $95.50	Facility		$75.86	$93.33	$95.50
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $17.38 / $17.38 / $144.54	Professional		$17.38	$17.38	$144.54
CareSource Facility/Professional Facility Modifier Low / Median / High Price $35.48 / $52.48 / $100.00	Facility		$35.48	$52.48	$100.00
CareSource Facility/Professional Professional Modifier Low / Median / High Price $35.48 / $38.90 / $48.98	Professional		$35.48	$38.90	$48.98
Cigna Facility/Professional Facility Modifier Low / Median / High Price $95.50 / $112.20 / $177.83	Facility		$95.50	$112.20	$177.83
Cigna Facility/Professional Professional Modifier Low / Median / High Price $39.81 / $85.11 / $109.65	Professional		$39.81	$85.11	$109.65
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $41.69 / $173.78 / $281.84	Facility		$41.69	$173.78	$281.84
DeanCare Facility/Professional Professional Modifier Low / Median / High Price $208.93 / $208.93 / $234.42	Professional		$208.93	$208.93	$234.42
Medica Facility/Professional Facility Modifier Low / Median / High Price $33.11 / $47.86 / $123.03	Facility		$33.11	$47.86	$123.03
Medica Facility/Professional Professional Modifier Low / Median / High Price $20.42 / $29.51 / $288.40	Professional		$20.42	$29.51	$288.40
Molina Facility/Professional Professional Modifier Low / Median / High Price $33.11 / $58.88 / $85.11	Professional		$33.11	$58.88	$85.11
Quartz Facility/Professional Professional Modifier Low / Median / High Price $61.66 / $89.13 / $147.91	Professional		$61.66	$89.13	$147.91
Quartz Facility/Professional Facility Modifier Low / Median / High Price $70.79 / $165.96 / $165.96	Facility		$70.79	$165.96	$165.96
Quartz Facility/Professional Professional Modifier Low / Median / High Price $41.69 / $194.98 / $288.40	Professional		$41.69	$194.98	$288.40
Security Health Facility/Professional Professional Modifier Low / Median / High Price $36.31 / $36.31 / $74.13	Professional		$36.31	$36.31	$74.13
Security Health Facility/Professional Professional Modifier Low / Median / High Price $36.31 / $141.25 / $213.80	Professional		$36.31	$141.25	$213.80
United Facility/Professional Facility Modifier Low / Median / High Price $30.90 / $30.90 / $41.69	Facility		$30.90	$30.90	$41.69
United Facility/Professional Professional Modifier Low / Median / High Price $14.79 / $28.18 / $77.62	Professional		$14.79	$28.18	$77.62