Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $60.26 / $257.04 / $812.83	Facility		$60.26	$257.04	$812.83
Aetna Facility/Professional Professional Modifier Low / Median / High Price $26.92 / $60.26 / $281.84	Professional		$26.92	$60.26	$281.84
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 $19.95 / $19.95 / $147.91	Professional		$19.95	$19.95	$147.91
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 / $190.55 / $302.00	Facility		$41.69	$190.55	$302.00
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 $43.65 / $147.91 / $346.74	Facility		$43.65	$147.91	$346.74
Medica Facility/Professional Professional Modifier Low / Median / High Price $20.42 / $41.69 / $199.53	Professional		$20.42	$41.69	$199.53
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 $75.86 / $213.80 / $213.80	Facility		$75.86	$213.80	$213.80
Quartz Facility/Professional Professional Modifier Low / Median / High Price $41.69 / $194.98 / $426.58	Professional		$41.69	$194.98	$426.58
Security Health Facility/Professional Professional Modifier Low / Median / High Price $74.13 / $74.13 / $144.54	Professional		$74.13	$74.13	$144.54
Security Health Facility/Professional Professional Modifier Low / Median / High Price $141.25 / $144.54 / $194.98	Professional		$141.25	$144.54	$194.98
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 / $27.54 / $77.62	Professional		$14.79	$27.54	$77.62