Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $77.62 / $131.83 / $208.93	Facility		$77.62	$131.83	$208.93
Aetna Facility/Professional Professional Modifier Low / Median / High Price $70.79 / $107.15 / $218.78	Professional		$70.79	$107.15	$218.78
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $85.11 / $120.23 / $239.88	Professional		$85.11	$120.23	$239.88
CareSource Facility/Professional Facility Modifier Low / Median / High Price $83.18 / $109.65 / $154.88	Facility		$83.18	$109.65	$154.88
CareSource Facility/Professional Professional Modifier Low / Median / High Price $107.15 / $144.54 / $239.88	Professional		$107.15	$144.54	$239.88
Cigna Facility/Professional Facility Modifier Low / Median / High Price $134.90 / $134.90 / $134.90	Facility		$134.90	$134.90	$134.90
Cigna Facility/Professional Professional Modifier Low / Median / High Price $91.20 / $151.36 / $288.40	Professional		$91.20	$151.36	$288.40
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $87.10 / $120.23 / $208.93	Facility		$87.10	$120.23	$208.93
DeanCare Facility/Professional Professional Modifier Low / Median / High Price $158.49 / $223.87 / $302.00	Professional		$158.49	$223.87	$302.00
Medica Facility/Professional Facility Modifier Low / Median / High Price $87.10 / $125.89 / $223.87	Facility		$87.10	$125.89	$223.87
Medica Facility/Professional Professional Modifier Low / Median / High Price $120.23 / $234.42 / $741.31	Professional		$120.23	$234.42	$741.31
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.36 / $64.57 / $131.83	Professional		$32.36	$64.57	$131.83
Quartz Facility/Professional Professional Modifier Low / Median / High Price $125.89 / $218.78 / $338.84	Professional		$125.89	$218.78	$338.84
Quartz Facility/Professional Facility Modifier Low / Median / High Price $165.96 / $165.96 / $588.84	Facility		$165.96	$165.96	$588.84
Quartz Facility/Professional Professional Modifier Low / Median / High Price $93.33 / $181.97 / $741.31	Professional		$93.33	$181.97	$741.31
Security Health Facility/Professional Professional Modifier Low / Median / High Price $173.78 / $173.78 / $218.78	Professional		$173.78	$173.78	$218.78
Security Health Facility/Professional Professional Modifier Low / Median / High Price $173.78 / $263.03 / $380.19	Professional		$173.78	$263.03	$380.19
United Facility/Professional Facility Modifier Low / Median / High Price $64.57 / $93.33 / $141.25	Facility		$64.57	$93.33	$141.25
United Facility/Professional Professional Modifier Low / Median / High Price $95.50 / $141.25 / $257.04	Professional		$95.50	$141.25	$257.04