Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $19.95 / $128.82 / $128.82	Facility		$19.95	$128.82	$128.82
Aetna Facility/Professional Professional Modifier Low / Median / High Price $114.82 / $173.78 / $446.68	Professional		$114.82	$173.78	$446.68
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $131.83 / $131.83 / $147.91	Professional		$131.83	$131.83	$147.91
CareSource Facility/Professional Facility Modifier Low / Median / High Price $128.82 / $128.82 / $128.82	Facility		$128.82	$128.82	$128.82
Cigna Facility/Professional Facility Modifier Low / Median / High Price $144.54 / $234.42 / $407.38	Facility		$144.54	$234.42	$407.38
Cigna Facility/Professional Professional Modifier Low / Median / High Price $114.82 / $134.90 / $144.54	Professional		$114.82	$134.90	$144.54
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $72.44 / $128.82 / $144.54	Facility		$72.44	$128.82	$144.54
Medica Facility/Professional Facility Modifier Low / Median / High Price $72.44 / $138.04 / $199.53	Facility		$72.44	$138.04	$199.53
Medica Facility/Professional Professional Modifier Low / Median / High Price $120.23 / $134.90 / $190.55	Professional		$120.23	$134.90	$190.55
Molina Facility/Professional Professional Modifier Low / Median / High Price $15.14 / $54.95 / $85.11	Professional		$15.14	$54.95	$85.11
Quartz Facility/Professional Professional Modifier Low / Median / High Price $87.10 / $162.18 / $218.78	Professional		$87.10	$162.18	$218.78
Quartz Facility/Professional Facility Modifier Low / Median / High Price $123.03 / $144.54 / $426.58	Facility		$123.03	$144.54	$426.58
Quartz Facility/Professional Professional Modifier Low / Median / High Price $144.54 / $144.54 / $144.54	Professional		$144.54	$144.54	$144.54
Security Health Facility/Professional Professional Modifier Low / Median / High Price $109.65 / $112.20 / $138.04	Professional		$109.65	$112.20	$138.04
United Facility/Professional Facility Modifier Low / Median / High Price $134.90 / $134.90 / $134.90	Facility		$134.90	$134.90	$134.90
United Facility/Professional Professional Modifier Low / Median / High Price $131.83 / $147.91 / $218.78	Professional		$131.83	$147.91	$218.78