Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $190.55 / $190.55 / $190.55	Facility		$190.55	$190.55	$190.55
Aetna Facility/Professional Professional Modifier Low / Median / High Price $190.55 / $190.55 / $323.59	Professional		$190.55	$190.55	$323.59
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $354.81 / $416.87 / $426.58	Facility		$354.81	$416.87	$426.58
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $173.78 / $173.78 / $257.04	Professional		$173.78	$173.78	$257.04
Cigna Facility/Professional Facility Modifier Low / Median / High Price $190.55 / $190.55 / $398.11	Facility		$190.55	$190.55	$398.11
Cigna Facility/Professional Professional Modifier Low / Median / High Price $190.55 / $194.98 / $354.81	Professional		$190.55	$194.98	$354.81
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $190.55 / $190.55 / $426.58	Facility		$190.55	$190.55	$426.58
Medica Facility/Professional Facility Modifier Low / Median / High Price $151.36 / $162.18 / $354.81	Facility		$151.36	$162.18	$354.81
Medica Facility/Professional Professional Modifier Low / Median / High Price $162.18 / $169.82 / $257.04	Professional		$162.18	$169.82	$257.04
Molina Facility/Professional Professional Modifier Low / Median / High Price $85.11 / $85.11 / $190.55	Professional		$85.11	$85.11	$190.55
Quartz Facility/Professional Professional Modifier Low / Median / High Price $190.55 / $407.38 / $630.96	Professional		$190.55	$407.38	$630.96
Quartz Facility/Professional Facility Modifier Low / Median / High Price $169.82 / $190.55 / $512.86	Facility		$169.82	$190.55	$512.86
Quartz Facility/Professional Professional Modifier Low / Median / High Price $190.55 / $190.55 / $190.55	Professional		$190.55	$190.55	$190.55
Security Health Facility/Professional Professional Modifier Low / Median / High Price $257.04 / $257.04 / $316.23	Professional		$257.04	$257.04	$316.23
United Facility/Professional Facility Modifier Low / Median / High Price $162.18 / $162.18 / $181.97	Facility		$162.18	$162.18	$181.97
United Facility/Professional Professional Modifier Low / Median / High Price $169.82 / $190.55 / $288.40	Professional		$169.82	$190.55	$288.40