Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $138.04 / $208.93 / $416.87	Facility		$138.04	$208.93	$416.87
Aetna Facility/Professional Professional Modifier Low / Median / High Price $138.04 / $138.04 / $234.42	Professional		$138.04	$138.04	$234.42
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $257.04 / $295.12 / $309.03	Facility		$257.04	$295.12	$309.03
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $138.04 / $138.04 / $173.78	Professional		$138.04	$138.04	$173.78
Cigna Facility/Professional Facility Modifier Low / Median / High Price $177.83 / $288.40 / $501.19	Facility		$177.83	$288.40	$501.19
Cigna Facility/Professional Professional Modifier Low / Median / High Price $141.25 / $177.83 / $354.81	Professional		$141.25	$177.83	$354.81
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $120.23 / $134.90 / $213.80	Facility		$120.23	$134.90	$213.80
DeanCare Facility/Professional Professional Modifier Low / Median / High Price $269.15 / $269.15 / $269.15	Professional		$269.15	$269.15	$269.15
Medica Facility/Professional Facility Modifier Low / Median / High Price $120.23 / $131.83 / $213.80	Facility		$120.23	$131.83	$213.80
Medica Facility/Professional Professional Modifier Low / Median / High Price $131.83 / $158.49 / $269.15	Professional		$131.83	$158.49	$269.15
Molina Facility/Professional Professional Modifier Low / Median / High Price $64.57 / $85.11 / $138.04	Professional		$64.57	$85.11	$138.04
Quartz Facility/Professional Professional Modifier Low / Median / High Price $138.04 / $147.91 / $371.54	Professional		$138.04	$147.91	$371.54
Quartz Facility/Professional Facility Modifier Low / Median / High Price $177.83 / $537.03 / $1,230.27	Facility		$177.83	$537.03	$1,230.27
Quartz Facility/Professional Professional Modifier Low / Median / High Price $177.83 / $177.83 / $177.83	Professional		$177.83	$177.83	$177.83
Security Health Facility/Professional Professional Modifier Low / Median / High Price $190.55 / $190.55 / $234.42	Professional		$190.55	$190.55	$234.42
United Facility/Professional Facility Modifier Low / Median / High Price $138.04 / $144.54 / $144.54	Facility		$138.04	$144.54	$144.54
United Facility/Professional Professional Modifier Low / Median / High Price $138.04 / $154.88 / $239.88	Professional		$138.04	$154.88	$239.88