Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $91.20 / $281.84 / $380.19	Facility		$91.20	$281.84	$380.19
Aetna Facility/Professional Professional Modifier Low / Median / High Price $60.26 / $97.72 / $275.42	Professional		$60.26	$97.72	$275.42
Aetna Facility/Professional Professional Modifier CQ Low / Median / High Price $131.83 / $131.83 / $131.83	Professional	CQ	$131.83	$131.83	$131.83
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $64.57 / $81.28 / $263.03	Professional		$64.57	$81.28	$263.03
CareSource Facility/Professional Facility Modifier Low / Median / High Price $93.33 / $125.89 / $165.96	Facility		$93.33	$125.89	$165.96
CareSource Facility/Professional Professional Modifier Low / Median / High Price $93.33 / $93.33 / $97.72	Professional		$93.33	$93.33	$97.72
Cigna Facility/Professional Facility Modifier Low / Median / High Price $64.57 / $269.15 / $363.08	Facility		$64.57	$269.15	$363.08
Cigna Facility/Professional Professional Modifier Low / Median / High Price $85.11 / $141.25 / $302.00	Professional		$85.11	$141.25	$302.00
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $63.10 / $83.18 / $199.53	Facility		$63.10	$83.18	$199.53
DeanCare Facility/Professional Professional Modifier Low / Median / High Price $165.96 / $190.55 / $288.40	Professional		$165.96	$190.55	$288.40
Medica Facility/Professional Facility Modifier Low / Median / High Price $81.28 / $213.80 / $316.23	Facility		$81.28	$213.80	$316.23
Medica Facility/Professional Professional Modifier Low / Median / High Price $74.13 / $128.82 / $323.59	Professional		$74.13	$128.82	$323.59
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.36 / $33.11 / $64.57	Professional		$32.36	$33.11	$64.57
Quartz Facility/Professional Professional Modifier Low / Median / High Price $109.65 / $223.87 / $316.23	Professional		$109.65	$223.87	$316.23
Quartz Facility/Professional Facility Modifier Low / Median / High Price $64.57 / $125.89 / $630.96	Facility		$64.57	$125.89	$630.96
Quartz Facility/Professional Professional Modifier Low / Median / High Price $97.72 / $426.58 / $630.96	Professional		$97.72	$426.58	$630.96
Security Health Facility/Professional Facility Modifier Low / Median / High Price $154.88 / $154.88 / $154.88	Facility		$154.88	$154.88	$154.88
Security Health Facility/Professional Professional Modifier Low / Median / High Price $117.49 / $204.17 / $281.84	Professional		$117.49	$204.17	$281.84
United Facility/Professional Facility Modifier Low / Median / High Price $107.15 / $107.15 / $107.15	Facility		$107.15	$107.15	$107.15
United Facility/Professional Professional Modifier Low / Median / High Price $74.13 / $85.11 / $165.96	Professional		$74.13	$85.11	$165.96