Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $25.70 / $25.70 / $128.82	Facility		$25.70	$25.70	$128.82
Aetna Facility/Professional Professional Modifier Low / Median / High Price $19.95 / $25.70 / $91.20	Professional		$19.95	$25.70	$91.20
Aetna Facility/Professional Professional Modifier CQ Low / Median / High Price $295.12 / $295.12 / $295.12	Professional	CQ	$295.12	$295.12	$295.12
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $23.44 / $27.54 / $95.50	Professional		$23.44	$27.54	$95.50
CareSource Facility/Professional Facility Modifier Low / Median / High Price $31.62 / $42.66 / $69.18	Facility		$31.62	$42.66	$69.18
CareSource Facility/Professional Professional Modifier Low / Median / High Price $31.62 / $31.62 / $33.11	Professional		$31.62	$31.62	$33.11
Cigna Facility/Professional Facility Modifier Low / Median / High Price $64.57 / $91.20 / $123.03	Facility		$64.57	$91.20	$123.03
Cigna Facility/Professional Professional Modifier Low / Median / High Price $28.84 / $50.12 / $102.33	Professional		$28.84	$50.12	$102.33
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $21.38 / $32.36 / $67.61	Facility		$21.38	$32.36	$67.61
DeanCare Facility/Professional Professional Modifier Low / Median / High Price $61.66 / $70.79 / $97.72	Professional		$61.66	$70.79	$97.72
Medica Facility/Professional Facility Modifier Low / Median / High Price $22.91 / $38.90 / $154.88	Facility		$22.91	$38.90	$154.88
Medica Facility/Professional Professional Modifier Low / Median / High Price $30.20 / $34.67 / $213.80	Professional		$30.20	$34.67	$213.80
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 $37.15 / $79.43 / $173.78	Professional		$37.15	$79.43	$173.78
Quartz Facility/Professional Facility Modifier Low / Median / High Price $64.57 / $81.28 / $213.80	Facility		$64.57	$81.28	$213.80
Quartz Facility/Professional Professional Modifier Low / Median / High Price $33.88 / $169.82 / $213.80	Professional		$33.88	$169.82	$213.80
Security Health Facility/Professional Facility Modifier Low / Median / High Price $93.33 / $93.33 / $93.33	Facility		$93.33	$93.33	$93.33
Security Health Facility/Professional Professional Modifier Low / Median / High Price $40.74 / $93.33 / $95.50	Professional		$40.74	$93.33	$95.50
United Facility/Professional Facility Modifier Low / Median / High Price $37.15 / $37.15 / $37.15	Facility		$37.15	$37.15	$37.15
United Facility/Professional Professional Modifier Low / Median / High Price $28.84 / $34.67 / $58.88	Professional		$28.84	$34.67	$58.88