Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $169.82 / $169.82 / $169.82	Facility		$169.82	$169.82	$169.82
Aetna Facility/Professional Professional Modifier Low / Median / High Price $114.82 / $154.88 / $194.98	Professional		$114.82	$154.88	$194.98
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $218.78 / $218.78 / $363.08	Facility		$218.78	$218.78	$363.08
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $165.96 / $204.17 / $234.42	Professional		$165.96	$204.17	$234.42
CareSource Facility/Professional Facility Modifier Low / Median / High Price $21.38 / $30.20 / $40.74	Facility		$21.38	$30.20	$40.74
CareSource Facility/Professional Professional Modifier Low / Median / High Price $22.39 / $30.20 / $50.12	Professional		$22.39	$30.20	$50.12
Cigna Facility/Professional Facility Modifier Low / Median / High Price $112.20 / $660.69 / $1,096.48	Facility		$112.20	$660.69	$1,096.48
Cigna Facility/Professional Professional Modifier Low / Median / High Price $107.15 / $257.04 / $316.23	Professional		$107.15	$257.04	$316.23
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $36.31 / $125.89 / $194.98	Facility		$36.31	$125.89	$194.98
DeanCare Facility/Professional Professional Modifier Low / Median / High Price $19.50 / $19.50 / $25.70	Professional		$19.50	$19.50	$25.70
Medica Facility/Professional Facility Modifier Low / Median / High Price $36.31 / $120.23 / $346.74	Facility		$36.31	$120.23	$346.74
Medica Facility/Professional Professional Modifier Low / Median / High Price $11.75 / $17.78 / $36.31	Professional		$11.75	$17.78	$36.31
Molina Facility/Professional Professional Modifier Low / Median / High Price $0.29 / $40.74 / $70.79	Professional		$0.29	$40.74	$70.79
Quartz Facility/Professional Professional Modifier Low / Median / High Price $22.39 / $42.66 / $67.61	Professional		$22.39	$42.66	$67.61
Quartz Facility/Professional Facility Modifier Low / Median / High Price $64.57 / $147.91 / $346.74	Facility		$64.57	$147.91	$346.74
Quartz Facility/Professional Professional Modifier Low / Median / High Price $107.15 / $125.89 / $147.91	Professional		$107.15	$125.89	$147.91
United Facility/Professional Facility Modifier Low / Median / High Price $13.18 / $16.60 / $549.54	Facility		$13.18	$16.60	$549.54
United Facility/Professional Professional Modifier Low / Median / High Price $11.75 / $17.78 / $81.28	Professional		$11.75	$17.78	$81.28