Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $51.29 / $107.15 / $257.04	Facility		$51.29	$107.15	$257.04
Aetna Facility/Professional Professional Modifier Low / Median / High Price $51.29 / $61.66 / $131.83	Professional		$51.29	$61.66	$131.83
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $20.42 / $20.42 / $204.17	Professional		$20.42	$20.42	$204.17
CareSource Facility/Professional Facility Modifier Low / Median / High Price $51.29 / $77.62 / $131.83	Facility		$51.29	$77.62	$131.83
CareSource Facility/Professional Professional Modifier Low / Median / High Price $51.29 / $56.23 / $72.44	Professional		$51.29	$56.23	$72.44
Cigna Facility/Professional Facility Modifier Low / Median / High Price $112.20 / $147.91 / $208.93	Facility		$112.20	$147.91	$208.93
Cigna Facility/Professional Professional Modifier Low / Median / High Price $52.48 / $112.20 / $158.49	Professional		$52.48	$112.20	$158.49
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $51.29 / $213.80 / $323.59	Facility		$51.29	$213.80	$323.59
DeanCare Facility/Professional Professional Modifier Low / Median / High Price $309.03 / $309.03 / $338.84	Professional		$309.03	$309.03	$338.84
Medica Facility/Professional Facility Modifier Low / Median / High Price $61.66 / $125.89 / $229.09	Facility		$61.66	$125.89	$229.09
Medica Facility/Professional Professional Modifier Low / Median / High Price $30.90 / $51.29 / $158.49	Professional		$30.90	$51.29	$158.49
Molina Facility/Professional Professional Modifier Low / Median / High Price $51.29 / $58.88 / $70.79	Professional		$51.29	$58.88	$70.79
Quartz Facility/Professional Professional Modifier Low / Median / High Price $83.18 / $120.23 / $169.82	Professional		$83.18	$120.23	$169.82
Quartz Facility/Professional Facility Modifier Low / Median / High Price $102.33 / $245.47 / $245.47	Facility		$102.33	$245.47	$245.47
Quartz Facility/Professional Professional Modifier Low / Median / High Price $39.81 / $204.17 / $257.04	Professional		$39.81	$204.17	$257.04
Security Health Facility/Professional Professional Modifier Low / Median / High Price $51.29 / $51.29 / $109.65	Professional		$51.29	$51.29	$109.65
Security Health Facility/Professional Facility Modifier Low / Median / High Price $44.67 / $57.54 / $61.66	Facility		$44.67	$57.54	$61.66
Security Health Facility/Professional Professional Modifier Low / Median / High Price $51.29 / $51.29 / $281.84	Professional		$51.29	$51.29	$281.84
United Facility/Professional Facility Modifier Low / Median / High Price $40.74 / $40.74 / $61.66	Facility		$40.74	$40.74	$61.66
United Facility/Professional Professional Modifier Low / Median / High Price $30.90 / $51.29 / $85.11	Professional		$30.90	$51.29	$85.11