Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $47.86 / $93.33 / $263.03	Facility		$47.86	$93.33	$263.03
Aetna Facility/Professional Professional Modifier Low / Median / High Price $23.44 / $43.65 / $181.97	Professional		$23.44	$43.65	$181.97
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $25.12 / $38.90 / $117.49	Professional		$25.12	$38.90	$117.49
CareSource Facility/Professional Facility Modifier Low / Median / High Price $19.05 / $26.30 / $74.13	Facility		$19.05	$26.30	$74.13
CareSource Facility/Professional Professional Modifier Low / Median / High Price $25.12 / $28.84 / $56.23	Professional		$25.12	$28.84	$56.23
Cigna Facility/Professional Facility Modifier Low / Median / High Price $66.07 / $77.62 / $123.03	Facility		$66.07	$77.62	$123.03
Cigna Facility/Professional Professional Modifier Low / Median / High Price $38.02 / $72.44 / $85.11	Professional		$38.02	$72.44	$85.11
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $23.44 / $34.67 / $74.13	Facility		$23.44	$34.67	$74.13
DeanCare Facility/Professional Professional Modifier Low / Median / High Price $45.71 / $60.26 / $77.62	Professional		$45.71	$60.26	$77.62
Medica Facility/Professional Facility Modifier Low / Median / High Price $23.44 / $40.74 / $114.82	Facility		$23.44	$40.74	$114.82
Medica Facility/Professional Professional Modifier Low / Median / High Price $27.54 / $48.98 / $158.49	Professional		$27.54	$48.98	$158.49
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 $32.36 / $57.54 / $83.18	Professional		$32.36	$57.54	$83.18
Quartz Facility/Professional Facility Modifier Low / Median / High Price $57.54 / $158.49 / $158.49	Facility		$57.54	$158.49	$158.49
Quartz Facility/Professional Professional Modifier Low / Median / High Price $33.88 / $128.82 / $158.49	Professional		$33.88	$128.82	$158.49
Security Health Facility/Professional Professional Modifier Low / Median / High Price $50.12 / $128.82 / $169.82	Professional		$50.12	$128.82	$169.82
United Facility/Professional Professional Modifier Low / Median / High Price $26.30 / $41.69 / $100.00	Professional		$26.30	$41.69	$100.00