Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $0.02 / $109.65 / $218.78	Facility		$0.02	$109.65	$218.78
Aetna Facility/Professional Professional Modifier Low / Median / High Price $72.44 / $77.62 / $165.96	Professional		$72.44	$77.62	$165.96
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $91.20 / $91.20 / $165.96	Facility		$91.20	$91.20	$165.96
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $74.13 / $74.13 / $93.33	Professional		$74.13	$74.13	$93.33
CareSource Facility/Professional Facility Modifier Low / Median / High Price $72.44 / $97.72 / $138.04	Facility		$72.44	$97.72	$138.04
CareSource Facility/Professional Professional Modifier Low / Median / High Price $72.44 / $81.28 / $169.82	Professional		$72.44	$81.28	$169.82
Cigna Facility/Professional Facility Modifier Low / Median / High Price $74.13 / $97.72 / $177.83	Facility		$74.13	$97.72	$177.83
Cigna Facility/Professional Professional Modifier Low / Median / High Price $74.13 / $79.43 / $151.36	Professional		$74.13	$79.43	$151.36
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $72.44 / $74.13 / $102.33	Facility		$72.44	$74.13	$102.33
DeanCare Facility/Professional Professional Modifier Low / Median / High Price $40.74 / $131.83 / $147.91	Professional		$40.74	$131.83	$147.91
Medica Facility/Professional Facility Modifier Low / Median / High Price $72.44 / $74.13 / $104.71	Facility		$72.44	$74.13	$104.71
Medica Facility/Professional Professional Modifier Low / Median / High Price $72.44 / $81.28 / $2,041.74	Professional		$72.44	$81.28	$2,041.74
Molina Facility/Professional Professional Modifier Low / Median / High Price $50.12 / $64.57 / $85.11	Professional		$50.12	$64.57	$85.11
Quartz Facility/Professional Professional Modifier Low / Median / High Price $74.13 / $114.82 / $218.78	Professional		$74.13	$114.82	$218.78
Quartz Facility/Professional Facility Modifier Low / Median / High Price $74.13 / $74.13 / $380.19	Facility		$74.13	$74.13	$380.19
Quartz Facility/Professional Professional Modifier Low / Median / High Price $74.13 / $134.90 / $2,041.74	Professional		$74.13	$134.90	$2,041.74
Security Health Facility/Professional Professional Modifier Low / Median / High Price $91.20 / $102.33 / $125.89	Professional		$91.20	$102.33	$125.89
United Facility/Professional Facility Modifier Low / Median / High Price $72.44 / $72.44 / $74.13	Facility		$72.44	$72.44	$74.13
United Facility/Professional Professional Modifier Low / Median / High Price $74.13 / $77.62 / $87.10	Professional		$74.13	$77.62	$87.10