Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $20.89 / $114.82 / $125.89	Facility		$20.89	$114.82	$125.89
Aetna Facility/Professional Professional Modifier Low / Median / High Price $12.88 / $15.85 / $26.92	Professional		$12.88	$15.85	$26.92
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $38.90 / $48.98 / $50.12	Facility		$38.90	$48.98	$50.12
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $7.94 / $7.94 / $72.44	Professional		$7.94	$7.94	$72.44
CareSource Facility/Professional Facility Modifier Low / Median / High Price $13.18 / $13.18 / $13.18	Facility		$13.18	$13.18	$13.18
CareSource Facility/Professional Professional Modifier Low / Median / High Price $18.20 / $18.20 / $18.20	Professional		$18.20	$18.20	$18.20
Cigna Facility/Professional Facility Modifier Low / Median / High Price $50.12 / $57.54 / $93.33	Facility		$50.12	$57.54	$93.33
Cigna Facility/Professional Professional Modifier Low / Median / High Price $9.55 / $23.44 / $56.23	Professional		$9.55	$23.44	$56.23
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $16.22 / $38.90 / $125.89	Facility		$16.22	$38.90	$125.89
DeanCare Facility/Professional Professional Modifier Low / Median / High Price $17.78 / $17.78 / $17.78	Professional		$17.78	$17.78	$17.78
Medica Facility/Professional Facility Modifier Low / Median / High Price $14.13 / $18.20 / $38.90	Facility		$14.13	$18.20	$38.90
Medica Facility/Professional Professional Modifier Low / Median / High Price $10.47 / $13.18 / $35.48	Professional		$10.47	$13.18	$35.48
Molina Facility/Professional Professional Modifier Low / Median / High Price $9.12 / $30.90 / $85.11	Professional		$9.12	$30.90	$85.11
Quartz Facility/Professional Professional Modifier Low / Median / High Price $20.42 / $42.66 / $63.10	Professional		$20.42	$42.66	$63.10
Quartz Facility/Professional Facility Modifier Low / Median / High Price $36.31 / $36.31 / $85.11	Facility		$36.31	$36.31	$85.11
Quartz Facility/Professional Professional Modifier Low / Median / High Price $9.55 / $9.55 / $9.55	Professional		$9.55	$9.55	$9.55
Security Health Facility/Professional Professional Modifier Low / Median / High Price $16.22 / $16.22 / $38.02	Professional		$16.22	$16.22	$38.02
Security Health Facility/Professional Professional Modifier Low / Median / High Price $16.22 / $95.50 / $112.20	Professional		$16.22	$95.50	$112.20
United Facility/Professional Facility Modifier Low / Median / High Price $12.02 / $14.45 / $21.88	Facility		$12.02	$14.45	$21.88
United Facility/Professional Professional Modifier Low / Median / High Price $7.59 / $13.18 / $36.31	Professional		$7.59	$13.18	$36.31