Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $77.62 / $87.10 / $114.82	Facility		$77.62	$87.10	$114.82
Aetna Facility/Professional Professional Modifier Low / Median / High Price $83.18 / $107.15 / $190.55	Professional		$83.18	$107.15	$190.55
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $123.03 / $123.03 / $123.03	Facility		$123.03	$123.03	$123.03
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $85.11 / $120.23 / $354.81	Professional		$85.11	$120.23	$354.81
CareSource Facility/Professional Facility Modifier Low / Median / High Price $79.43 / $109.65 / $204.17	Facility		$79.43	$109.65	$204.17
CareSource Facility/Professional Professional Modifier Low / Median / High Price $107.15 / $165.96 / $275.42	Professional		$107.15	$165.96	$275.42
Cigna Facility/Professional Facility Modifier Low / Median / High Price $323.59 / $426.58 / $630.96	Facility		$323.59	$426.58	$630.96
Cigna Facility/Professional Professional Modifier Low / Median / High Price $95.50 / $218.78 / $426.58	Professional		$95.50	$218.78	$426.58
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $104.71 / $120.23 / $177.83	Facility		$104.71	$120.23	$177.83
DeanCare Facility/Professional Professional Modifier Low / Median / High Price $151.36 / $204.17 / $316.23	Professional		$151.36	$204.17	$316.23
Medica Facility/Professional Facility Modifier Low / Median / High Price $104.71 / $120.23 / $177.83	Facility		$104.71	$120.23	$177.83
Medica Facility/Professional Professional Modifier Low / Median / High Price $102.33 / $190.55 / $741.31	Professional		$102.33	$190.55	$741.31
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.36 / $33.11 / $199.53	Professional		$32.36	$33.11	$199.53
Quartz Facility/Professional Professional Modifier Low / Median / High Price $144.54 / $213.80 / $354.81	Professional		$144.54	$213.80	$354.81
Quartz Facility/Professional Facility Modifier Low / Median / High Price $263.03 / $263.03 / $645.65	Facility		$263.03	$263.03	$645.65
Quartz Facility/Professional Professional Modifier Low / Median / High Price $75.86 / $144.54 / $758.58	Professional		$75.86	$144.54	$758.58
Security Health Facility/Professional Professional Modifier Low / Median / High Price $173.78 / $295.12 / $371.54	Professional		$173.78	$295.12	$371.54
United Facility/Professional Facility Modifier Low / Median / High Price $74.13 / $77.62 / $123.03	Facility		$74.13	$77.62	$123.03
United Facility/Professional Professional Modifier Low / Median / High Price $100.00 / $154.88 / $363.08	Professional		$100.00	$154.88	$363.08