Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $91.20 / $281.84 / $691.83	Facility		$91.20	$281.84	$691.83
Aetna Facility/Professional Professional Modifier Low / Median / High Price $52.48 / $75.86 / $338.84	Professional		$52.48	$75.86	$338.84
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $151.36 / $190.55 / $194.98	Facility		$151.36	$190.55	$194.98
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $34.67 / $34.67 / $288.40	Professional		$34.67	$34.67	$288.40
CareSource Facility/Professional Facility Modifier Low / Median / High Price $70.79 / $104.71 / $199.53	Facility		$70.79	$104.71	$199.53
CareSource Facility/Professional Professional Modifier Low / Median / High Price $70.79 / $77.62 / $97.72	Professional		$70.79	$77.62	$97.72
Cigna Facility/Professional Facility Modifier Low / Median / High Price $194.98 / $223.87 / $363.08	Facility		$194.98	$223.87	$363.08
Cigna Facility/Professional Professional Modifier Low / Median / High Price $81.28 / $177.83 / $218.78	Professional		$81.28	$177.83	$218.78
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $85.11 / $389.05 / $562.34	Facility		$85.11	$389.05	$562.34
DeanCare Facility/Professional Professional Modifier Low / Median / High Price $416.87 / $416.87 / $467.74	Professional		$416.87	$416.87	$467.74
Medica Facility/Professional Facility Modifier Low / Median / High Price $70.79 / $190.55 / $354.81	Facility		$70.79	$190.55	$354.81
Medica Facility/Professional Professional Modifier Low / Median / High Price $40.74 / $61.66 / $575.44	Professional		$40.74	$61.66	$575.44
Molina Facility/Professional Professional Modifier Low / Median / High Price $33.11 / $64.57 / $138.04	Professional		$33.11	$64.57	$138.04
Quartz Facility/Professional Professional Modifier Low / Median / High Price $123.03 / $165.96 / $239.88	Professional		$123.03	$165.96	$239.88
Quartz Facility/Professional Facility Modifier Low / Median / High Price $151.36 / $331.13 / $331.13	Facility		$151.36	$331.13	$331.13
Quartz Facility/Professional Professional Modifier Low / Median / High Price $46.77 / $389.05 / $575.44	Professional		$46.77	$389.05	$575.44
Security Health Facility/Professional Professional Modifier Low / Median / High Price $79.43 / $79.43 / $147.91	Professional		$79.43	$79.43	$147.91
Security Health Facility/Professional Professional Modifier Low / Median / High Price $79.43 / $204.17 / $436.52	Professional		$79.43	$204.17	$436.52
United Facility/Professional Facility Modifier Low / Median / High Price $63.10 / $63.10 / $85.11	Facility		$63.10	$63.10	$85.11
United Facility/Professional Professional Modifier Low / Median / High Price $29.51 / $56.23 / $134.90	Professional		$29.51	$56.23	$134.90