Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $323.59 / $489.78 / $870.96	Facility		$323.59	$489.78	$870.96
Aetna Facility/Professional Facility Modifier 25 Low / Median / High Price $389.05 / $524.81 / $630.96	Facility	25	$389.05	$524.81	$630.96
Aetna Facility/Professional Professional Modifier Low / Median / High Price $30.20 / $51.29 / $112.20	Professional		$30.20	$51.29	$112.20
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $467.74 / $575.44 / $575.44	Facility		$467.74	$575.44	$575.44
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $39.81 / $91.20 / $147.91	Professional		$39.81	$91.20	$147.91
CareSource Facility/Professional Facility Modifier Low / Median / High Price $38.90 / $51.29 / $83.18	Facility		$38.90	$51.29	$83.18
CareSource Facility/Professional Professional Modifier Low / Median / High Price $41.69 / $51.29 / $56.23	Professional		$41.69	$51.29	$56.23
Cigna Facility/Professional Facility Modifier Low / Median / High Price $93.33 / $123.03 / $199.53	Facility		$93.33	$123.03	$199.53
Cigna Facility/Professional Professional Modifier Low / Median / High Price $42.66 / $89.13 / $134.90	Professional		$42.66	$89.13	$134.90
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $36.31 / $53.70 / $109.65	Facility		$36.31	$53.70	$109.65
DeanCare Facility/Professional Professional Modifier Low / Median / High Price $74.13 / $93.33 / $123.03	Professional		$74.13	$93.33	$123.03
Medica Facility/Professional Facility Modifier Low / Median / High Price $35.48 / $56.23 / $114.82	Facility		$35.48	$56.23	$114.82
Medica Facility/Professional Professional Modifier Low / Median / High Price $40.74 / $72.44 / $501.19	Professional		$40.74	$72.44	$501.19
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 $63.10 / $95.50 / $141.25	Professional		$63.10	$95.50	$141.25
Quartz Facility/Professional Facility Modifier Low / Median / High Price $77.62 / $77.62 / $77.62	Facility		$77.62	$77.62	$77.62
Quartz Facility/Professional Professional Modifier Low / Median / High Price $45.71 / $208.93 / $501.19	Professional		$45.71	$208.93	$501.19
Security Health Facility/Professional Professional Modifier Low / Median / High Price $75.86 / $138.04 / $173.78	Professional		$75.86	$138.04	$173.78
United Facility/Professional Professional Modifier Low / Median / High Price $39.81 / $61.66 / $114.82	Professional		$39.81	$61.66	$114.82