Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $57.54 / $107.15 / $131.83	Facility		$57.54	$107.15	$131.83
Aetna Facility/Professional Professional Modifier Low / Median / High Price $30.90 / $40.74 / $72.44	Professional		$30.90	$40.74	$72.44
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $104.71 / $128.82 / $131.83	Facility		$104.71	$128.82	$131.83
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $19.50 / $19.50 / $194.98	Professional		$19.50	$19.50	$194.98
Cigna Facility/Professional Facility Modifier Low / Median / High Price $131.83 / $154.88 / $245.47	Facility		$131.83	$154.88	$245.47
Cigna Facility/Professional Professional Modifier Low / Median / High Price $54.95 / $93.33 / $151.36	Professional		$54.95	$93.33	$151.36
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $53.70 / $173.78 / $281.84	Facility		$53.70	$173.78	$281.84
DeanCare Facility/Professional Professional Modifier Low / Median / High Price $288.40 / $288.40 / $323.59	Professional		$288.40	$288.40	$323.59
Medica Facility/Professional Facility Modifier Low / Median / High Price $45.71 / $61.66 / $169.82	Facility		$45.71	$61.66	$169.82
Medica Facility/Professional Professional Modifier Low / Median / High Price $21.38 / $30.90 / $288.40	Professional		$21.38	$30.90	$288.40
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.36 / $54.95 / $85.11	Professional		$32.36	$54.95	$85.11
Quartz Facility/Professional Professional Modifier Low / Median / High Price $83.18 / $123.03 / $158.49	Professional		$83.18	$123.03	$158.49
Quartz Facility/Professional Facility Modifier Low / Median / High Price $95.50 / $229.09 / $229.09	Facility		$95.50	$229.09	$229.09
Quartz Facility/Professional Professional Modifier Low / Median / High Price $44.67 / $239.88 / $288.40	Professional		$44.67	$239.88	$288.40
Security Health Facility/Professional Professional Modifier Low / Median / High Price $36.31 / $36.31 / $102.33	Professional		$36.31	$36.31	$102.33
Security Health Facility/Professional Professional Modifier Low / Median / High Price $36.31 / $141.25 / $263.03	Professional		$36.31	$141.25	$263.03
United Facility/Professional Facility Modifier Low / Median / High Price $38.90 / $38.90 / $57.54	Facility		$38.90	$38.90	$57.54
United Facility/Professional Professional Modifier Low / Median / High Price $20.42 / $28.84 / $79.43	Professional		$20.42	$28.84	$79.43