Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $41.69 / $41.69 / $79.43	Facility		$41.69	$41.69	$79.43
Aetna Facility/Professional Professional Modifier Low / Median / High Price $38.02 / $70.79 / $154.88	Professional		$38.02	$70.79	$154.88
Aetna Facility/Professional Professional Modifier 25 Low / Median / High Price $72.44 / $85.11 / $186.21	Professional	25	$72.44	$85.11	$186.21
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $60.26 / $123.03 / $257.04	Professional		$60.26	$123.03	$257.04
CareSource Facility/Professional Facility Modifier Low / Median / High Price $43.65 / $43.65 / $58.88	Facility		$43.65	$43.65	$58.88
CareSource Facility/Professional Professional Modifier Low / Median / High Price $104.71 / $104.71 / $104.71	Professional		$104.71	$104.71	$104.71
Cigna Facility/Professional Facility Modifier Low / Median / High Price $371.54 / $371.54 / $457.09	Facility		$371.54	$371.54	$457.09
Cigna Facility/Professional Professional Modifier Low / Median / High Price $44.67 / $93.33 / $199.53	Professional		$44.67	$93.33	$199.53
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $42.66 / $66.07 / $123.03	Facility		$42.66	$66.07	$123.03
DeanCare Facility/Professional Professional Modifier Low / Median / High Price $64.57 / $123.03 / $229.09	Professional		$64.57	$123.03	$229.09
Medica Facility/Professional Facility Modifier Low / Median / High Price $38.90 / $64.57 / $107.15	Facility		$38.90	$64.57	$107.15
Medica Facility/Professional Professional Modifier Low / Median / High Price $72.44 / $114.82 / $549.54	Professional		$72.44	$114.82	$549.54
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.36 / $33.11 / $104.71	Professional		$32.36	$33.11	$104.71
Quartz Facility/Professional Professional Modifier Low / Median / High Price $51.29 / $109.65 / $269.15	Professional		$51.29	$109.65	$269.15
Quartz Facility/Professional Professional Modifier Low / Median / High Price $50.12 / $173.78 / $549.54	Professional		$50.12	$173.78	$549.54
Security Health Facility/Professional Professional Modifier Low / Median / High Price $77.62 / $147.91 / $275.42	Professional		$77.62	$147.91	$275.42
United Facility/Professional Professional Modifier Low / Median / High Price $42.66 / $75.86 / $154.88	Professional		$42.66	$75.86	$154.88