Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $57.54 / $74.13 / $87.10	Facility		$57.54	$74.13	$87.10
Aetna Facility/Professional Professional Modifier Low / Median / High Price $64.57 / $89.13 / $173.78	Professional		$64.57	$89.13	$173.78
Aetna Facility/Professional Professional Modifier 25 Low / Median / High Price $134.90 / $134.90 / $134.90	Professional	25	$134.90	$134.90	$134.90
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $81.28 / $81.28 / $81.28	Facility		$81.28	$81.28	$81.28
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $64.57 / $91.20 / $269.15	Professional		$64.57	$91.20	$269.15
CareSource Facility/Professional Facility Modifier Low / Median / High Price $60.26 / $83.18 / $151.36	Facility		$60.26	$83.18	$151.36
CareSource Facility/Professional Professional Modifier Low / Median / High Price $81.28 / $125.89 / $208.93	Professional		$81.28	$125.89	$208.93
Cigna Facility/Professional Facility Modifier Low / Median / High Price $239.88 / $323.59 / $478.63	Facility		$239.88	$323.59	$478.63
Cigna Facility/Professional Professional Modifier Low / Median / High Price $61.66 / $162.18 / $323.59	Professional		$61.66	$162.18	$323.59
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $77.62 / $91.20 / $134.90	Facility		$77.62	$91.20	$134.90
DeanCare Facility/Professional Professional Modifier Low / Median / High Price $109.65 / $154.88 / $229.09	Professional		$109.65	$154.88	$229.09
Medica Facility/Professional Facility Modifier Low / Median / High Price $77.62 / $89.13 / $134.90	Facility		$77.62	$89.13	$134.90
Medica Facility/Professional Professional Modifier Low / Median / High Price $72.44 / $128.82 / $562.34	Professional		$72.44	$128.82	$562.34
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.36 / $33.11 / $85.11	Professional		$32.36	$33.11	$85.11
Quartz Facility/Professional Professional Modifier Low / Median / High Price $107.15 / $158.49 / $269.15	Professional		$107.15	$158.49	$269.15
Quartz Facility/Professional Facility Modifier Low / Median / High Price $199.53 / $199.53 / $489.78	Facility		$199.53	$199.53	$489.78
Quartz Facility/Professional Professional Modifier Low / Median / High Price $45.71 / $107.15 / $575.44	Professional		$45.71	$107.15	$575.44
Security Health Facility/Professional Professional Modifier Low / Median / High Price $120.23 / $223.87 / $275.42	Professional		$120.23	$223.87	$275.42
United Facility/Professional Facility Modifier Low / Median / High Price $54.95 / $57.54 / $93.33	Facility		$54.95	$57.54	$93.33
United Facility/Professional Professional Modifier Low / Median / High Price $70.79 / $114.82 / $275.42	Professional		$70.79	$114.82	$275.42