Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $91.20 / $173.78 / $239.88	Facility		$91.20	$173.78	$239.88
Aetna Facility/Professional Professional Modifier Low / Median / High Price $87.10 / $169.82 / $380.19	Professional		$87.10	$169.82	$380.19
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $100.00 / $154.88 / $281.84	Professional		$100.00	$154.88	$281.84
CareSource Facility/Professional Facility Modifier Low / Median / High Price $89.13 / $117.49 / $165.96	Facility		$89.13	$117.49	$165.96
CareSource Facility/Professional Professional Modifier Low / Median / High Price $123.03 / $165.96 / $275.42	Professional		$123.03	$165.96	$275.42
Cigna Facility/Professional Facility Modifier Low / Median / High Price $309.03 / $407.38 / $645.65	Facility		$309.03	$407.38	$645.65
Cigna Facility/Professional Professional Modifier Low / Median / High Price $93.33 / $186.21 / $346.74	Professional		$93.33	$186.21	$346.74
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $77.62 / $117.49 / $218.78	Facility		$77.62	$117.49	$218.78
DeanCare Facility/Professional Professional Modifier Low / Median / High Price $169.82 / $239.88 / $346.74	Professional		$169.82	$239.88	$346.74
Medica Facility/Professional Facility Modifier Low / Median / High Price $75.86 / $117.49 / $239.88	Facility		$75.86	$117.49	$239.88
Medica Facility/Professional Professional Modifier Low / Median / High Price $123.03 / $239.88 / $812.83	Professional		$123.03	$239.88	$812.83
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.36 / $63.10 / $128.82	Professional		$32.36	$63.10	$128.82
Quartz Facility/Professional Professional Modifier Low / Median / High Price $131.83 / $234.42 / $380.19	Professional		$131.83	$234.42	$380.19
Quartz Facility/Professional Facility Modifier Low / Median / High Price $177.83 / $177.83 / $602.56	Facility		$177.83	$177.83	$602.56
Quartz Facility/Professional Professional Modifier Low / Median / High Price $93.33 / $213.80 / $812.83	Professional		$93.33	$213.80	$812.83
Security Health Facility/Professional Professional Modifier Low / Median / High Price $158.49 / $158.49 / $218.78	Professional		$158.49	$158.49	$218.78
Security Health Facility/Professional Professional Modifier Low / Median / High Price $165.96 / $257.04 / $380.19	Professional		$165.96	$257.04	$380.19
United Facility/Professional Facility Modifier Low / Median / High Price $109.65 / $109.65 / $109.65	Facility		$109.65	$109.65	$109.65
United Facility/Professional Professional Modifier Low / Median / High Price $95.50 / $144.54 / $269.15	Professional		$95.50	$144.54	$269.15