Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $70.79 / $95.50 / $151.36	Facility		$70.79	$95.50	$151.36
Aetna Facility/Professional Professional Modifier Low / Median / High Price $75.86 / $100.00 / $218.78	Professional		$75.86	$100.00	$218.78
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $66.07 / $66.07 / $66.07	Facility		$66.07	$66.07	$66.07
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $79.43 / $112.20 / $323.59	Professional		$79.43	$112.20	$323.59
CareSource Facility/Professional Facility Modifier Low / Median / High Price $72.44 / $100.00 / $181.97	Facility		$72.44	$100.00	$181.97
CareSource Facility/Professional Professional Modifier Low / Median / High Price $87.10 / $134.90 / $223.87	Professional		$87.10	$134.90	$223.87
Cigna Facility/Professional Facility Modifier Low / Median / High Price $263.03 / $346.74 / $512.86	Facility		$263.03	$346.74	$512.86
Cigna Facility/Professional Professional Modifier Low / Median / High Price $64.57 / $123.03 / $331.13	Professional		$64.57	$123.03	$331.13
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $91.20 / $102.33 / $151.36	Facility		$91.20	$102.33	$151.36
DeanCare Facility/Professional Professional Modifier Low / Median / High Price $128.82 / $165.96 / $263.03	Professional		$128.82	$165.96	$263.03
Medica Facility/Professional Facility Modifier Low / Median / High Price $89.13 / $102.33 / $154.88	Facility		$89.13	$102.33	$154.88
Medica Facility/Professional Professional Modifier Low / Median / High Price $85.11 / $144.54 / $630.96	Professional		$85.11	$144.54	$630.96
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.36 / $33.11 / $112.20	Professional		$32.36	$33.11	$112.20
Quartz Facility/Professional Professional Modifier Low / Median / High Price $117.49 / $173.78 / $309.03	Professional		$117.49	$173.78	$309.03
Quartz Facility/Professional Facility Modifier Low / Median / High Price $239.88 / $239.88 / $602.56	Facility		$239.88	$239.88	$602.56
Quartz Facility/Professional Professional Modifier Low / Median / High Price $60.26 / $95.50 / $630.96	Professional		$60.26	$95.50	$630.96
Security Health Facility/Professional Professional Modifier Low / Median / High Price $131.83 / $251.19 / $338.84	Professional		$131.83	$251.19	$338.84
United Facility/Professional Facility Modifier Low / Median / High Price $79.43 / $102.33 / $134.90	Facility		$79.43	$102.33	$134.90
United Facility/Professional Professional Modifier Low / Median / High Price $85.11 / $125.89 / $316.23	Professional		$85.11	$125.89	$316.23