Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $77.62 / $112.20 / $13,182.57	Facility		$77.62	$112.20	$13,182.57
Aetna Facility/Professional Professional Modifier Low / Median / High Price $74.13 / $75.86 / $112.20	Professional		$74.13	$75.86	$112.20
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $93.33 / $93.33 / $165.96	Facility		$93.33	$93.33	$165.96
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $74.13 / $74.13 / $112.20	Professional		$74.13	$74.13	$112.20
CareSource Facility/Professional Facility Modifier Low / Median / High Price $75.86 / $102.33 / $141.25	Facility		$75.86	$102.33	$141.25
CareSource Facility/Professional Professional Modifier Low / Median / High Price $75.86 / $83.18 / $173.78	Professional		$75.86	$83.18	$173.78
Cigna Facility/Professional Facility Modifier Low / Median / High Price $74.13 / $95.50 / $190.55	Facility		$74.13	$95.50	$190.55
Cigna Facility/Professional Professional Modifier Low / Median / High Price $74.13 / $77.62 / $151.36	Professional		$74.13	$77.62	$151.36
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $75.86 / $75.86 / $87.10	Facility		$75.86	$75.86	$87.10
DeanCare Facility/Professional Professional Modifier Low / Median / High Price $85.11 / $151.36 / $257.04	Professional		$85.11	$151.36	$257.04
Medica Facility/Professional Facility Modifier Low / Median / High Price $75.86 / $75.86 / $109.65	Facility		$75.86	$75.86	$109.65
Medica Facility/Professional Professional Modifier Low / Median / High Price $75.86 / $85.11 / $363.08	Professional		$75.86	$85.11	$363.08
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 / $117.49 / $229.09	Professional		$74.13	$117.49	$229.09
Quartz Facility/Professional Facility Modifier Low / Median / High Price $74.13 / $74.13 / $467.74	Facility		$74.13	$74.13	$467.74
Quartz Facility/Professional Professional Modifier Low / Median / High Price $74.13 / $141.25 / $363.08	Professional		$74.13	$141.25	$363.08
Security Health Facility/Professional Professional Modifier Low / Median / High Price $100.00 / $100.00 / $123.03	Professional		$100.00	$100.00	$123.03
United Facility/Professional Facility Modifier Low / Median / High Price $74.13 / $75.86 / $75.86	Facility		$74.13	$75.86	$75.86
United Facility/Professional Professional Modifier Low / Median / High Price $74.13 / $79.43 / $89.13	Professional		$74.13	$79.43	$89.13