Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $57.54 / $57.54 / $147.91	Facility		$57.54	$57.54	$147.91
Aetna Facility/Professional Professional Modifier Low / Median / High Price $38.90 / $58.88 / $112.20	Professional		$38.90	$58.88	$112.20
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $114.82 / $114.82 / $190.55	Facility		$114.82	$114.82	$190.55
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $97.72 / $107.15 / $128.82	Professional		$97.72	$107.15	$128.82
CareSource Facility/Professional Facility Modifier Low / Median / High Price $102.33 / $134.90 / $239.88	Facility		$102.33	$134.90	$239.88
CareSource Facility/Professional Professional Modifier Low / Median / High Price $158.49 / $158.49 / $158.49	Professional		$158.49	$158.49	$158.49
Cigna Facility/Professional Facility Modifier Low / Median / High Price $70.79 / $269.15 / $562.34	Facility		$70.79	$269.15	$562.34
Cigna Facility/Professional Professional Modifier Low / Median / High Price $51.29 / $165.96 / $218.78	Professional		$51.29	$165.96	$218.78
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $36.31 / $91.20 / $134.90	Facility		$36.31	$91.20	$134.90
DeanCare Facility/Professional Professional Modifier Low / Median / High Price $102.33 / $162.18 / $208.93	Professional		$102.33	$162.18	$208.93
Medica Facility/Professional Facility Modifier Low / Median / High Price $57.54 / $112.20 / $588.84	Facility		$57.54	$112.20	$588.84
Medica Facility/Professional Professional Modifier Low / Median / High Price $52.48 / $67.61 / $134.90	Professional		$52.48	$67.61	$134.90
Molina Facility/Professional Professional Modifier Low / Median / High Price $50.12 / $70.79 / $85.11	Professional		$50.12	$70.79	$85.11
Quartz Facility/Professional Professional Modifier Low / Median / High Price $114.82 / $173.78 / $354.81	Professional		$114.82	$173.78	$354.81
Quartz Facility/Professional Facility Modifier Low / Median / High Price $70.79 / $229.09 / $630.96	Facility		$70.79	$229.09	$630.96
Quartz Facility/Professional Professional Modifier Low / Median / High Price $51.29 / $102.33 / $741.31	Professional		$51.29	$102.33	$741.31
United Facility/Professional Facility Modifier Low / Median / High Price $52.48 / $60.26 / $186.21	Facility		$52.48	$60.26	$186.21
United Facility/Professional Professional Modifier Low / Median / High Price $44.67 / $56.23 / $97.72	Professional		$44.67	$56.23	$97.72