Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $54.95 / $91.20 / $158.49	Facility		$54.95	$91.20	$158.49
Aetna Facility/Professional Professional Modifier Low / Median / High Price $10.96 / $25.12 / $91.20	Professional		$10.96	$25.12	$91.20
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $35.48 / $44.67 / $45.71	Facility		$35.48	$44.67	$45.71
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $10.00 / $10.00 / $57.54	Professional		$10.00	$10.00	$57.54
CareSource Facility/Professional Facility Modifier Low / Median / High Price $12.30 / $41.69 / $41.69	Facility		$12.30	$41.69	$41.69
CareSource Facility/Professional Professional Modifier Low / Median / High Price $16.60 / $16.60 / $16.60	Professional		$16.60	$16.60	$16.60
Cigna Facility/Professional Facility Modifier Low / Median / High Price $44.67 / $52.48 / $83.18	Facility		$44.67	$52.48	$83.18
Cigna Facility/Professional Professional Modifier Low / Median / High Price $19.05 / $23.99 / $57.54	Professional		$19.05	$23.99	$57.54
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $10.72 / $33.11 / $95.50	Facility		$10.72	$33.11	$95.50
Medica Facility/Professional Facility Modifier Low / Median / High Price $10.72 / $21.38 / $128.82	Facility		$10.72	$21.38	$128.82
Medica Facility/Professional Professional Modifier Low / Median / High Price $10.00 / $16.60 / $35.48	Professional		$10.00	$16.60	$35.48
Molina Facility/Professional Professional Modifier Low / Median / High Price $8.32 / $32.36 / $64.57	Professional		$8.32	$32.36	$64.57
Quartz Facility/Professional Professional Modifier Low / Median / High Price $20.89 / $41.69 / $53.70	Professional		$20.89	$41.69	$53.70
Quartz Facility/Professional Facility Modifier Low / Median / High Price $33.11 / $33.11 / $77.62	Facility		$33.11	$33.11	$77.62
Quartz Facility/Professional Professional Modifier Low / Median / High Price $7.76 / $7.94 / $11.75	Professional		$7.76	$7.94	$11.75
Security Health Facility/Professional Professional Modifier Low / Median / High Price $14.45 / $14.45 / $35.48	Professional		$14.45	$14.45	$35.48
Security Health Facility/Professional Professional Modifier Low / Median / High Price $14.45 / $51.29 / $91.20	Professional		$14.45	$51.29	$91.20
United Facility/Professional Facility Modifier Low / Median / High Price $9.12 / $13.18 / $19.95	Facility		$9.12	$13.18	$19.95
United Facility/Professional Professional Modifier Low / Median / High Price $10.00 / $16.60 / $35.48	Professional		$10.00	$16.60	$35.48