Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $22.91 / $51.29 / $83.18	Facility		$22.91	$51.29	$83.18
Aetna Facility/Professional Professional Modifier Low / Median / High Price $28.18 / $52.48 / $134.90	Professional		$28.18	$52.48	$134.90
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $81.28 / $81.28 / $134.90	Facility		$81.28	$81.28	$134.90
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $69.18 / $75.86 / $91.20	Professional		$69.18	$75.86	$91.20
CareSource Facility/Professional Facility Modifier Low / Median / High Price $72.44 / $81.28 / $173.78	Facility		$72.44	$81.28	$173.78
CareSource Facility/Professional Professional Modifier Low / Median / High Price $93.33 / $93.33 / $93.33	Professional		$93.33	$93.33	$93.33
Cigna Facility/Professional Facility Modifier Low / Median / High Price $45.71 / $190.55 / $407.38	Facility		$45.71	$190.55	$407.38
Cigna Facility/Professional Professional Modifier Low / Median / High Price $33.11 / $117.49 / $154.88	Professional		$33.11	$117.49	$154.88
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $37.15 / $61.66 / $95.50	Facility		$37.15	$61.66	$95.50
DeanCare Facility/Professional Professional Modifier Low / Median / High Price $72.44 / $100.00 / $125.89	Professional		$72.44	$100.00	$125.89
Medica Facility/Professional Facility Modifier Low / Median / High Price $27.54 / $66.07 / $354.81	Facility		$27.54	$66.07	$354.81
Medica Facility/Professional Professional Modifier Low / Median / High Price $30.20 / $41.69 / $91.20	Professional		$30.20	$41.69	$91.20
Molina Facility/Professional Professional Modifier Low / Median / High Price $40.74 / $58.88 / $85.11	Professional		$40.74	$58.88	$85.11
Quartz Facility/Professional Professional Modifier Low / Median / High Price $81.28 / $123.03 / $208.93	Professional		$81.28	$123.03	$208.93
Quartz Facility/Professional Facility Modifier Low / Median / High Price $45.71 / $162.18 / $416.87	Facility		$45.71	$162.18	$416.87
Quartz Facility/Professional Professional Modifier Low / Median / High Price $33.11 / $66.07 / $524.81	Professional		$33.11	$66.07	$524.81
United Facility/Professional Facility Modifier Low / Median / High Price $30.20 / $38.02 / $107.15	Facility		$30.20	$38.02	$107.15
United Facility/Professional Professional Modifier Low / Median / High Price $26.92 / $39.81 / $67.61	Professional		$26.92	$39.81	$67.61