Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $61.66 / $104.71 / $114.82	Facility		$61.66	$104.71	$114.82
Aetna Facility/Professional Professional Modifier Low / Median / High Price $40.74 / $41.69 / $147.91	Professional		$40.74	$41.69	$147.91
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $16.60 / $16.60 / $165.96	Professional		$16.60	$16.60	$165.96
CareSource Facility/Professional Facility Modifier Low / Median / High Price $41.69 / $61.66 / $104.71	Facility		$41.69	$61.66	$104.71
CareSource Facility/Professional Professional Modifier Low / Median / High Price $41.69 / $45.71 / $57.54	Professional		$41.69	$45.71	$57.54
Cigna Facility/Professional Facility Modifier Low / Median / High Price $91.20 / $120.23 / $169.82	Facility		$91.20	$120.23	$169.82
Cigna Facility/Professional Professional Modifier Low / Median / High Price $47.86 / $89.13 / $128.82	Professional		$47.86	$89.13	$128.82
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $41.69 / $173.78 / $263.03	Facility		$41.69	$173.78	$263.03
DeanCare Facility/Professional Professional Modifier Low / Median / High Price $245.47 / $245.47 / $275.42	Professional		$245.47	$245.47	$275.42
Medica Facility/Professional Facility Modifier Low / Median / High Price $41.69 / $50.12 / $144.54	Facility		$41.69	$50.12	$144.54
Medica Facility/Professional Professional Modifier Low / Median / High Price $26.30 / $43.65 / $204.17	Professional		$26.30	$43.65	$204.17
Molina Facility/Professional Professional Modifier Low / Median / High Price $41.69 / $54.95 / $70.79	Professional		$41.69	$54.95	$70.79
Quartz Facility/Professional Professional Modifier Low / Median / High Price $67.61 / $97.72 / $134.90	Professional		$67.61	$97.72	$134.90
Quartz Facility/Professional Facility Modifier Low / Median / High Price $83.18 / $194.98 / $194.98	Facility		$83.18	$194.98	$194.98
Quartz Facility/Professional Professional Modifier Low / Median / High Price $31.62 / $165.96 / $204.17	Professional		$31.62	$165.96	$204.17
Security Health Facility/Professional Professional Modifier Low / Median / High Price $89.13 / $89.13 / $89.13	Professional		$89.13	$89.13	$89.13
Security Health Facility/Professional Facility Modifier Low / Median / High Price $50.12 / $50.12 / $50.12	Facility		$50.12	$50.12	$50.12
Security Health Facility/Professional Professional Modifier Low / Median / High Price $41.69 / $41.69 / $223.87	Professional		$41.69	$41.69	$223.87
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 $24.55 / $41.69 / $72.44	Professional		$24.55	$41.69	$72.44