Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $18.20 / $41.69 / $58.88	Facility		$18.20	$41.69	$58.88
Aetna Facility/Professional Professional Modifier Low / Median / High Price $18.20 / $18.20 / $95.50	Professional		$18.20	$18.20	$95.50
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $18.20 / $18.20 / $22.91	Professional		$18.20	$18.20	$22.91
CareSource Facility/Professional Facility Modifier Low / Median / High Price $26.30 / $26.30 / $27.54	Facility		$26.30	$26.30	$27.54
Cigna Facility/Professional Facility Modifier Low / Median / High Price $18.20 / $38.90 / $67.61	Facility		$18.20	$38.90	$67.61
Cigna Facility/Professional Professional Modifier Low / Median / High Price $18.62 / $22.91 / $33.88	Professional		$18.62	$22.91	$33.88
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $18.62 / $18.62 / $40.74	Facility		$18.62	$18.62	$40.74
Medica Facility/Professional Facility Modifier Low / Median / High Price $18.62 / $18.62 / $40.74	Facility		$18.62	$18.62	$40.74
Medica Facility/Professional Professional Modifier Low / Median / High Price $18.62 / $18.62 / $28.18	Professional		$18.62	$18.62	$28.18
Molina Facility/Professional Professional Modifier Low / Median / High Price $61.66 / $64.57 / $85.11	Professional		$61.66	$64.57	$85.11
Quartz Facility/Professional Professional Modifier Low / Median / High Price $18.20 / $19.50 / $56.23	Professional		$18.20	$19.50	$56.23
Quartz Facility/Professional Facility Modifier Low / Median / High Price $18.20 / $18.20 / $93.33	Facility		$18.20	$18.20	$93.33
Quartz Facility/Professional Professional Modifier Low / Median / High Price $18.20 / $18.20 / $18.20	Professional		$18.20	$18.20	$18.20
Security Health Facility/Professional Professional Modifier Low / Median / High Price $24.55 / $24.55 / $30.20	Professional		$24.55	$24.55	$30.20
United Facility/Professional Facility Modifier Low / Median / High Price $18.62 / $18.62 / $18.62	Facility		$18.62	$18.62	$18.62
United Facility/Professional Professional Modifier Low / Median / High Price $18.20 / $18.20 / $28.84	Professional		$18.20	$18.20	$28.84