Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $21.88 / $131.83 / $707.95	Facility		$21.88	$131.83	$707.95
Aetna Facility/Professional Professional Modifier Low / Median / High Price $19.05 / $36.31 / $95.50	Professional		$19.05	$36.31	$95.50
Aetna Facility/Professional Professional Modifier 25 Low / Median / High Price $64.57 / $64.57 / $64.57	Professional	25	$64.57	$64.57	$64.57
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $25.12 / $25.12 / $25.12	Facility		$25.12	$25.12	$25.12
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $20.89 / $35.48 / $141.25	Professional		$20.89	$35.48	$141.25
CareSource Facility/Professional Facility Modifier Low / Median / High Price $18.20 / $25.12 / $70.79	Facility		$18.20	$25.12	$70.79
CareSource Facility/Professional Professional Modifier Low / Median / High Price $24.55 / $38.02 / $63.10	Professional		$24.55	$38.02	$63.10
Cigna Facility/Professional Facility Modifier Low / Median / High Price $74.13 / $97.72 / $144.54	Facility		$74.13	$97.72	$144.54
Cigna Facility/Professional Professional Modifier Low / Median / High Price $19.95 / $38.02 / $93.33	Professional		$19.95	$38.02	$93.33
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $23.44 / $30.20 / $58.88	Facility		$23.44	$30.20	$58.88
DeanCare Facility/Professional Professional Modifier Low / Median / High Price $34.67 / $46.77 / $74.13	Professional		$34.67	$46.77	$74.13
Medica Facility/Professional Facility Modifier Low / Median / High Price $23.44 / $29.51 / $58.88	Facility		$23.44	$29.51	$58.88
Medica Facility/Professional Professional Modifier Low / Median / High Price $28.84 / $53.70 / $407.38	Professional		$28.84	$53.70	$407.38
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.36 / $33.11 / $70.79	Professional		$32.36	$33.11	$70.79
Quartz Facility/Professional Professional Modifier Low / Median / High Price $31.62 / $47.86 / $79.43	Professional		$31.62	$47.86	$79.43
Quartz Facility/Professional Facility Modifier Low / Median / High Price $58.88 / $58.88 / $229.09	Facility		$58.88	$58.88	$229.09
Quartz Facility/Professional Professional Modifier Low / Median / High Price $19.95 / $37.15 / $407.38	Professional		$19.95	$37.15	$407.38
Security Health Facility/Professional Professional Modifier Low / Median / High Price $33.88 / $66.07 / $85.11	Professional		$33.88	$66.07	$85.11
United Facility/Professional Facility Modifier Low / Median / High Price $21.88 / $43.65 / $45.71	Facility		$21.88	$43.65	$45.71
United Facility/Professional Professional Modifier Low / Median / High Price $26.92 / $42.66 / $87.10	Professional		$26.92	$42.66	$87.10