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 / $36.31 / $89.13	Professional		$28.84	$36.31	$89.13
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 $17.38 / $17.38 / $173.78	Professional		$17.38	$17.38	$173.78
CareSource Facility/Professional Facility Modifier Low / Median / High Price $41.69 / $41.69 / $56.23	Facility		$41.69	$41.69	$56.23
CareSource Facility/Professional Professional Modifier Low / Median / High Price $41.69 / $41.69 / $58.88	Professional		$41.69	$41.69	$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 / $93.33 / $128.82	Professional		$47.86	$93.33	$128.82
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $50.12 / $173.78 / $281.84	Facility		$50.12	$173.78	$281.84
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 / $64.57 / $363.08	Facility		$39.81	$64.57	$363.08
Medica Facility/Professional Professional Modifier Low / Median / High Price $20.42 / $29.51 / $323.59	Professional		$20.42	$29.51	$323.59
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 $72.44 / $107.15 / $147.91	Professional		$72.44	$107.15	$147.91
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 $44.67 / $208.93 / $323.59	Professional		$44.67	$208.93	$323.59
Security Health Facility/Professional Professional Modifier Low / Median / High Price $89.13 / $89.13 / $281.84	Professional		$89.13	$89.13	$281.84
Security Health Facility/Professional Professional Modifier Low / Median / High Price $125.89 / $229.09 / $281.84	Professional		$125.89	$229.09	$281.84
United Facility/Professional Facility Modifier Low / Median / High Price $33.11 / $33.11 / $50.12	Facility		$33.11	$33.11	$50.12
United Facility/Professional Professional Modifier Low / Median / High Price $17.38 / $28.84 / $79.43	Professional		$17.38	$28.84	$79.43