Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $102.33 / $134.90 / $288.40	Facility		$102.33	$134.90	$288.40
CareSource Facility/Professional Facility Modifier Low / Median / High Price $169.82 / $194.98 / $309.03	Facility		$169.82	$194.98	$309.03
Cigna Facility/Professional Facility Modifier Low / Median / High Price $416.87 / $478.63 / $776.25	Facility		$416.87	$478.63	$776.25
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $123.03 / $169.82 / $316.23	Facility		$123.03	$169.82	$316.23
Medica Facility/Professional Facility Modifier Low / Median / High Price $134.90 / $169.82 / $316.23	Facility		$134.90	$169.82	$316.23
Quartz Facility/Professional Professional Modifier Low / Median / High Price $229.09 / $371.54 / $478.63	Professional		$229.09	$371.54	$478.63
Quartz Facility/Professional Facility Modifier Low / Median / High Price $295.12 / $1,023.29 / $1,023.29	Facility		$295.12	$1,023.29	$1,023.29
United Facility/Professional Facility Modifier Low / Median / High Price $104.71 / $128.82 / $134.90	Facility		$104.71	$128.82	$134.90