Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $44.67 / $44.67 / $69.18	Facility		$44.67	$44.67	$69.18
Aetna Facility/Professional Professional Modifier Low / Median / High Price $44.67 / $64.57 / $158.49	Professional		$44.67	$64.57	$158.49
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $91.20 / $91.20 / $151.36	Facility		$91.20	$91.20	$151.36
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $77.62 / $85.11 / $102.33	Professional		$77.62	$85.11	$102.33
CareSource Facility/Professional Facility Modifier Low / Median / High Price $81.28 / $112.20 / $190.55	Facility		$81.28	$112.20	$190.55
CareSource Facility/Professional Professional Modifier Low / Median / High Price $128.82 / $128.82 / $128.82	Professional		$128.82	$128.82	$128.82
Cigna Facility/Professional Facility Modifier Low / Median / High Price $57.54 / $208.93 / $446.68	Facility		$57.54	$208.93	$446.68
Cigna Facility/Professional Professional Modifier Low / Median / High Price $42.66 / $128.82 / $173.78	Professional		$42.66	$128.82	$173.78
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $38.02 / $69.18 / $107.15	Facility		$38.02	$69.18	$107.15
DeanCare Facility/Professional Professional Modifier Low / Median / High Price $81.28 / $134.90 / $169.82	Professional		$81.28	$134.90	$169.82
Medica Facility/Professional Facility Modifier Low / Median / High Price $45.71 / $89.13 / $467.74	Facility		$45.71	$89.13	$467.74
Medica Facility/Professional Professional Modifier Low / Median / High Price $40.74 / $53.70 / $102.33	Professional		$40.74	$53.70	$102.33
Molina Facility/Professional Professional Modifier Low / Median / High Price $41.69 / $58.88 / $85.11	Professional		$41.69	$58.88	$85.11
Quartz Facility/Professional Professional Modifier Low / Median / High Price $91.20 / $138.04 / $281.84	Professional		$91.20	$138.04	$281.84
Quartz Facility/Professional Facility Modifier Low / Median / High Price $57.54 / $181.97 / $489.78	Facility		$57.54	$181.97	$489.78
Quartz Facility/Professional Professional Modifier Low / Median / High Price $42.66 / $85.11 / $588.84	Professional		$42.66	$85.11	$588.84
United Facility/Professional Facility Modifier Low / Median / High Price $41.69 / $47.86 / $147.91	Facility		$41.69	$47.86	$147.91
United Facility/Professional Professional Modifier Low / Median / High Price $35.48 / $44.67 / $77.62	Professional		$35.48	$44.67	$77.62