Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $50.12 / $93.33 / $114.82	Facility		$50.12	$93.33	$114.82
Aetna Facility/Professional Professional Modifier Low / Median / High Price $28.84 / $38.90 / $69.18	Professional		$28.84	$38.90	$69.18
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $89.13 / $112.20 / $114.82	Facility		$89.13	$112.20	$114.82
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $20.42 / $20.42 / $173.78	Professional		$20.42	$20.42	$173.78
CareSource Facility/Professional Facility Modifier Low / Median / High Price $41.69 / $63.10 / $117.49	Facility		$41.69	$63.10	$117.49
CareSource Facility/Professional Professional Modifier Low / Median / High Price $41.69 / $45.71 / $58.88	Professional		$41.69	$45.71	$58.88
Cigna Facility/Professional Facility Modifier Low / Median / High Price $114.82 / $134.90 / $213.80	Facility		$114.82	$134.90	$213.80
Cigna Facility/Professional Professional Modifier Low / Median / High Price $47.86 / $100.00 / $131.83	Professional		$47.86	$100.00	$131.83
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $50.12 / $208.93 / $331.13	Facility		$50.12	$208.93	$331.13
DeanCare Facility/Professional Professional Modifier Low / Median / High Price $251.19 / $251.19 / $275.42	Professional		$251.19	$251.19	$275.42
Medica Facility/Professional Facility Modifier Low / Median / High Price $39.81 / $56.23 / $144.54	Facility		$39.81	$56.23	$144.54
Medica Facility/Professional Professional Modifier Low / Median / High Price $24.55 / $35.48 / $346.74	Professional		$24.55	$35.48	$346.74
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.36 / $58.88 / $85.11	Professional		$32.36	$58.88	$85.11
Quartz Facility/Professional Professional Modifier Low / Median / High Price $72.44 / $107.15 / $177.83	Professional		$72.44	$107.15	$177.83
Quartz Facility/Professional Facility Modifier Low / Median / High Price $83.18 / $199.53 / $199.53	Facility		$83.18	$199.53	$199.53
Quartz Facility/Professional Professional Modifier Low / Median / High Price $50.12 / $234.42 / $346.74	Professional		$50.12	$234.42	$346.74
Security Health Facility/Professional Professional Modifier Low / Median / High Price $42.66 / $42.66 / $89.13	Professional		$42.66	$42.66	$89.13
Security Health Facility/Professional Professional Modifier Low / Median / High Price $42.66 / $120.23 / $229.09	Professional		$42.66	$120.23	$229.09
United Facility/Professional Facility Modifier Low / Median / High Price $37.15 / $37.15 / $50.12	Facility		$37.15	$37.15	$50.12
United Facility/Professional Professional Modifier Low / Median / High Price $17.38 / $33.11 / $85.11	Professional		$17.38	$33.11	$85.11